Archives of cardiovascular diseases · 2026
Associated diseases and diuretic dosage to predict mortality in transthyretin amyloid cardiomyopathy.
СтатьяНазвание и аннотация: Перевод в очереди
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Algalarrondo Vincent, Lairez Olivier, Narbeburu Marion, Fournier Pauline, Costa Jerome, Pelcot Francoise, Farrugia Agnes, Durand-Zaleski Isabelle, Lilliu Herve, Bartoli Mathilde, Fievez Stephane, Rudant Jeremie, Coste Agathe, Noirot Cosson Charlotte, Squara Pierre Alexandre, Canali Giorgia, de Neuville Bertrand, Slama Michel S, Charron Philippe, Damy Thibaud
Аннотация
BACKGROUND: Transthyretin amyloidosis can lead to transthyretin amyloid cardiomyopathy (ATTR-CM) and heart failure.
AIMS: To describe the prevalence of cardiac and extracardiac diseases in patients with ATTR-CM and examine mortality predictors, including diuretic dosage, using the French National Health Database.
METHODS: Patients with ATTR-CM and their medical characteristics were identified from the French database from 2011 to 2019. Diuretic doses were categorized into four classes (furosemide dose: level 1<20mg; level 2 20 to <60mg; level 3 60 to<120mg; level 4 ≥120mg). Predictive factors for mortality were examined.
RESULTS: Of 7804 patients with ATTR-CM, 33.0% were on level 1 diuretics, 25.8% on level 2, 15.8% on level 3 and 25.3% on level 4 at diagnosis. Leading extracardiac conditions included kidney disease (37.0%), diabetes (29.5%), neurologic disorders (17.9%), gastrointestinal disorders (15.7%) and musculoskeletal conditions (11.8%). Median (95% confidence interval [CI]) survival was 3.1 (3.0-3.3) years. Multivariable analysis identified age at diagnosis (hazard ratio [HR] 1.482, 95% CI 1.400-1.558), male sex (HR 1.258, 95% CI 1.125-1.406), diuretic dose (HR 1.380, 95% CI 1.315-1.449), heart failure (HR 1.251, 95% CI 1.090-1.437), arrhythmia/conduction disorder (HR 1.143, 95% CI 1.001-1.306), kidney disease (HR 1.224, 95% CI 1.104-1.358), gastrointestinal disorder (HR 1.143, 95% CI 1.000-1.307) and diabetes (HR 1.192, 95% CI 1.071-1.326) as significantly associated with mortality.
CONCLUSION: Patients with ATTR-CM face a significant burden of associated diseases requiring comprehensive management alongside their ATTR-CM treatment. Beyond addressing these comorbidities, diuretic dosage emerges as a pivotal prognostic indicator.
AIMS: To describe the prevalence of cardiac and extracardiac diseases in patients with ATTR-CM and examine mortality predictors, including diuretic dosage, using the French National Health Database.
METHODS: Patients with ATTR-CM and their medical characteristics were identified from the French database from 2011 to 2019. Diuretic doses were categorized into four classes (furosemide dose: level 1<20mg; level 2 20 to <60mg; level 3 60 to<120mg; level 4 ≥120mg). Predictive factors for mortality were examined.
RESULTS: Of 7804 patients with ATTR-CM, 33.0% were on level 1 diuretics, 25.8% on level 2, 15.8% on level 3 and 25.3% on level 4 at diagnosis. Leading extracardiac conditions included kidney disease (37.0%), diabetes (29.5%), neurologic disorders (17.9%), gastrointestinal disorders (15.7%) and musculoskeletal conditions (11.8%). Median (95% confidence interval [CI]) survival was 3.1 (3.0-3.3) years. Multivariable analysis identified age at diagnosis (hazard ratio [HR] 1.482, 95% CI 1.400-1.558), male sex (HR 1.258, 95% CI 1.125-1.406), diuretic dose (HR 1.380, 95% CI 1.315-1.449), heart failure (HR 1.251, 95% CI 1.090-1.437), arrhythmia/conduction disorder (HR 1.143, 95% CI 1.001-1.306), kidney disease (HR 1.224, 95% CI 1.104-1.358), gastrointestinal disorder (HR 1.143, 95% CI 1.000-1.307) and diabetes (HR 1.192, 95% CI 1.071-1.326) as significantly associated with mortality.
CONCLUSION: Patients with ATTR-CM face a significant burden of associated diseases requiring comprehensive management alongside their ATTR-CM treatment. Beyond addressing these comorbidities, diuretic dosage emerges as a pivotal prognostic indicator.