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Cardiac Amyloidosis Versus Other Restrictive Cardiomyopathies: A Retrospective Analysis of Cardiovascular Outcomes

Andrew Sagalov1, Waqas Ullah2, Yevgeniy Brailovsky3

  • 1Department of Internal Medicine, SIU School of Medicine, Springfield, IL, USA.

Clinical Medicine Insights. Cardiology
|November 29, 2024
PubMed

Insights

Cardiac amyloidosis increases stroke and ventricular tachycardia risks compared to other restrictive cardiomyopathies. In-hospital mortality and most arrhythmias were similar, but further analysis of amyloidosis subtypes is needed.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Electrophysiology

Background:

  • Cardiac amyloidosis (CA) and other restrictive cardiomyopathies (RCM) have distinct cardiovascular risk profiles.
  • Increased screening has led to more CA diagnoses, necessitating analysis of its outcomes.
  • Previous literature has not well-characterized the arrhythmic burden and cardiovascular risks of CA versus other RCMs.

Purpose of the Study:

  • To compare the cardiovascular risks and arrhythmic burden of cardiac amyloidosis with other types of restrictive cardiomyopathies.
  • To analyze outcomes including stroke, ventricular tachycardia, atrial fibrillation, and in-hospital mortality.

Main Methods:

  • A retrospective analysis of the National Inpatient Sample (NIS) database from 2016-2019.
  • Inclusion of adult patients diagnosed with cardiac amyloidosis or other RCMs (e.g., hemochromatosis, cardiac sarcoid).
  • Discharge-weighted analysis using survey regressions to account for sample characteristics and weights.

Main Results:

  • Cardiac amyloidosis (N=8365) showed a significantly increased risk of stroke (OR=3.91) and ventricular tachycardia (OR=1.98) compared to other RCM (N=4980).
  • CA had a decreased risk of atrial fibrillation (OR=0.56).
  • In-hospital mortality (P=.72) and risks of heart block and supraventricular arrhythmias were similar between groups.

Conclusions:

  • Cardiac amyloidosis is associated with higher risks of stroke and ventricular tachycardia than other RCMs.
  • In-hospital mortality and most arrhythmias did not significantly differ between CA and other RCMs.
  • Subgroup analysis of light chain (AL) and transthyretin (ATTR) amyloidosis is recommended to further define CA cardiovascular risks.
Abstract

Keywords:
Cardiac amyloidosisarrhythmianational inpatient sampleoutcomes analysisrestrictive cardiomyopathy

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