Multiorgan Dysfunction and Associated Prognosis in Transthyretin Cardiac Amyloidosis

Area of Science:

• Cardiology
• Biomarkers
• Amyloidosis

Background:

• Transthyretin cardiac amyloidosis (ATTR-CA) is a fatal cardiomyopathy.
• The prognostic significance of multiorgan dysfunction biomarkers in ATTR-CA is poorly understood.

Purpose of the Study:

• To characterize ATTR-CA using blood biomarkers.
• To assess the association between these biomarkers and patient prognosis.

Main Methods:

• Retrospective cohort study of 2566 ATTR-CA patients (2007-2023).
• Analysis of common blood biomarkers including urea, alkaline phosphatase, troponin, and C-reactive protein.
• Multivariable Cox regression to determine independent predictors of mortality.

Main Results:

• Anemia, high urea, hyperbilirubinemia, elevated alkaline phosphatase, and troponin were prevalent.
• These abnormalities were more common in p.(V142I) hereditary ATTR-CA and with increased cardiac disease severity.
• Anemia, high urea, hyperbilirubinemia, elevated alkaline phosphatase, hyponatremia, and high troponin-T independently predicted mortality.

Conclusions:

• Biomarker abnormalities are common in ATTR-CA, reflecting its complex nature.
• Several biomarkers are independently associated with mortality in ATTR-CA patients.
• Further clinical trials are needed to explore if targeting these biomarkers can improve outcomes.