Amyloidosis cases rose sharply after 2018; cardiac amyloidosis had higher mortality than non-cardiac, with overall mortality improving but cardiovascular mortality stable.
Does cardiac involvement worsen overall and cardiovascular mortality in patients with amyloidosis?
Cardiac involvement in amyloidosis is associated with significantly worse overall and cardiovascular mortality compared to non-cardiac amyloidosis, despite temporal improvements in overall mortality.
Absolute Event Rate: 0% vs 0%
Abstract Background The epidemiology and outcomes of amyloidosis remain poorly understood due to its rarity and poor prognosis. Purpose We aimed to analyze temporal trends in the incidence, prevalence, and outcomes of amyloidosis over 13 years, focusing on the impact of cardiac involvement. Methods We used data from a nationwide cohort study to analyze trends in overall and cardiac amyloidosis from 2009 to 2022. Amyloidosis was identified using ICD-10 code E85 or V121 from the Rare Intractable Diseases Program, with cardiac amyloidosis defined by the presence of heart failure, cardiomyopathy, atrial fibrillation, or pacemaker implantation. The analysis was conducted for the full study period and for three sub-periods: 2009-2013, 2014-2018, and 2019-2022. Results Incident and prevalent cases of amyloidosis gradually increased, with a sharp rise after 2018 (Figure 1). Of the 5,165 individuals with new-onset amyloidosis, 2,306 (44.6%) had cardiac amyloidosis, and 2,859 (55.4%) had non-cardiac amyloidosis. Cardiac amyloidosis was more common in elderly patients (≥65 years: 61.0% vs. 33.7%, p 0.001) and males (57.5% vs. 52.1%, p 0.001) compared to non-cardiac cases. After 1:1 propensity score matching, cardiac amyloidosis showed significantly higher overall and cardiovascular mortality than non-cardiac amyloidosis . While overall mortality improved significantly over time in both groups, cardiovascular mortality showed only a numerical improvement (Figure 2). Conclusions Our study demonstrated a gradual increase in amyloidosis cases, with worse outcomes in cardiac amyloidosis. Although overall mortality improved, the relatively static cardiovascular mortality suggests a need for further clinical attention.incidence and prevalence of amyloidosis overall and CV mortality
Jung et al. (Sat,) reported a other. Amyloidosis cases rose sharply after 2018; cardiac amyloidosis had higher mortality than non-cardiac, with overall mortality improving but cardiovascular mortality stable.