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Clinical presentation and prognosis of transthyretin cardiac amyloidosis according to gender. Analysis of the Galician registry of cardiac amyloidosis (AMIGAL).
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Enríquez-Vázquez Daniel, Barge-Caballero Gonzalo, Porto-Souto Mario, López-Pérez Manuel, López-López Andrea, González-Babarro Eva, Gutiérrez-Feijoo Mario, Bilbao-Quesada Raquel, Gómez-Otero Inés, Varela-Román Alfonso, Crespo-Leiro María G, Barge-Caballero Eduardo
Аннотация
INTRODUCTION AND OBJECTIVES: Sex differences in clinical presentation of ATTR-CA have been described, although published information is scarce. We aimed to compare baseline characteristics and outcomes between women and men with ATTR-CA.
METHODS: We evaluated all patients with ATTR-CA included in the Galician registry of cardiac amyloidosis (AMIGAL) between January 1st, 2018 and September 30th, 2023.
RESULTS: We included 385 patients with ATTR-CA - 95 women (24.7%) and 290 men (75.3%), with a median age of 82.5 years. Female sex presented more frequently NYHA class ≥ III (36.8% vs. 25.2%, P=0.028) and had higher LVEF (56.0% vs. 52.6%, P=0.003) and indexed left ventricular maximum thickness (10.2mm/m2 vs. 9.2mm/m2, P=0.001). Women received more thiazide diuretics (18.9% vs. 10.3%, P=0.028) and less SGLT2i (15.8% vs. 27.2%, P=0.024) and tafamidis (15.8% vs. 26.6%, P=0.033). Incidence of HF hospitalizations was lower in female sex (IR 167.39 vs. 245.61, P=0.033). There was no differences in mean survival, which was 4.1 years in both sexes.
CONCLUSIONS: Women with AC-ATTR presented with worse functional class, higher LVEF and higher left ventricular thicknesses than men. Female patients received less frequently SGLT2i and tafamidis, and were admitted to hospital for HF less frequently compared to male patients, while survival was similar.
METHODS: We evaluated all patients with ATTR-CA included in the Galician registry of cardiac amyloidosis (AMIGAL) between January 1st, 2018 and September 30th, 2023.
RESULTS: We included 385 patients with ATTR-CA - 95 women (24.7%) and 290 men (75.3%), with a median age of 82.5 years. Female sex presented more frequently NYHA class ≥ III (36.8% vs. 25.2%, P=0.028) and had higher LVEF (56.0% vs. 52.6%, P=0.003) and indexed left ventricular maximum thickness (10.2mm/m2 vs. 9.2mm/m2, P=0.001). Women received more thiazide diuretics (18.9% vs. 10.3%, P=0.028) and less SGLT2i (15.8% vs. 27.2%, P=0.024) and tafamidis (15.8% vs. 26.6%, P=0.033). Incidence of HF hospitalizations was lower in female sex (IR 167.39 vs. 245.61, P=0.033). There was no differences in mean survival, which was 4.1 years in both sexes.
CONCLUSIONS: Women with AC-ATTR presented with worse functional class, higher LVEF and higher left ventricular thicknesses than men. Female patients received less frequently SGLT2i and tafamidis, and were admitted to hospital for HF less frequently compared to male patients, while survival was similar.