Diagnostic pathways to wild-type transthyretin amyloid cardiomyopathy: a multicentre network study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Tini Giacomo, Milani Paolo, Zampieri Mattia, Caponetti Angelo G, Fabris Francesca, Foli Andrea, Argirò Alessia, Mazzoni Carlotta, Gagliardi Christian, Longhi Simone, Saturi Giulia, Vergaro Giuseppe, Aimo Alberto, Russo Domitilla, Varrà Guerino G, Serenelli Matteo, Fabbri Gioele, De Michieli Laura, Palmiero Giuseppe, Ciliberti Giuseppe, Carigi Samuela, Sessarego Eugenio, Mandoli Giulia E, Ricci Lucchi Giulia, Rella Valeria, Monti Enrico, Gardini Elisa, Bartolotti Michela, Crotti Lia, Merli Elisa, Mussinelli Roberta, Vianello Pier Filippo, Cameli Matteo, Marzo Francesca, Guerra Federico, Limongelli Giuseppe, Cipriani Alberto, Perlini Stefano, Obici Laura, Perfetto Federico, Autore Camillo, Porto Italo, Rapezzi Claudio, Sinagra Gianfranco, Merlo Marco, Musumeci Beatrice, Emdin Michele, Biagini Elena, Cappelli Francesco, Palladini Giovanni, Canepa Marco
Аннотация
METHODS AND RESULTS: This was a retrospective study of patients diagnosed with ATTRwt-CA at 17 Italian referral centres for CA. Patients were categorized into different 'pathways' according to the medical reason that triggered the diagnosis of ATTRwt-CA (hypertrophic cardiomyopathy [HCM] pathway, heart failure [HF] pathway, incidental imaging or incidental clinical pathway). Prognosis was investigated with all-cause mortality as endpoint. Overall, 1281 ATTRwt-CA patients were included in the study. The diagnostic pathway leading to ATTRwt-CA diagnosis was HCM in 7% of patients, HF in 51%, incidental imaging in 23%, incidental clinical in 19%. Patients in the HF pathway, as compared to the others, were older and had a greater prevalence of New York Heart Association (NYHA) class III-IV and chronic kidney disease. Survival was significantly worse in the HF versus other pathways, but similar among the three others. In multivariate model, older age at diagnosis, NYHA class III-IV and some comorbidities but not the HF pathway were independently associated with worse survival.
CONCLUSIONS: Half of contemporary ATTRwt-CA diagnoses occur in a HF setting. These patients had worse clinical profile and outcome than those diagnosed either due to suspected HCM or incidentally, although prognosis remained primarily related to age, NYHA functional class and comorbidities rather than the diagnostic pathway itself.