Cardiac amyloidosis worsens prognosis in patients with heart failure: findings from the PREVAMIC study.

Autor: Ruiz Hueso R; Hospital Universitario Virgen Macarena, Sevilla, Spain., Salamanca Bautista P; Hospital Universitario Virgen Macarena, Sevilla, Spain; Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain. Electronic address: msalamanca2@us.es., Quesada Simón MA; Hospital Universitario La Paz, Madrid, Spain., Yun S; Unidad de Insuficiencia Cardiaca Comunitaria, Servicios de Cardiología y Medicina Interna, Hospital Universitario de Bellvitge. Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain., Conde Martel A; Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain., Morales Rull JL; Hospital Universitario Arnau de Vilanova, Lleida, Spain., Fiteni Mera I; Hospital Royo Villanova, Zaragoza, Spain., Abad Pérez D; Hospital Universitario de Getafe, Getafe, Madrid, Spain., Páez Rubio I; Hospital Juan Ramón Jiménez, Huelva, Spain., Aramburu Bodas Ó; Hospital Universitario Virgen Macarena, Sevilla, Spain; Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain.
Jazyk: angličtina
Zdroj: Revista clinica espanola [Rev Clin Esp (Barc)] 2024 Jul 18. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1016/j.rceng.2024.07.006
Abstrakt: Background and Objectives: Cardiac amyloidosis (CA) is a common pathology in elderly patients that usually presents as heart failure (HF). However, it is not clear whether CA associated with HF has a worse prognosis compared with HF due to other etiologies.
Material and Methods: Prospective, observational cohort study that recruited patients ≥65 years of age with HF in 30 Spanish centers. The cohort was divided according to whether the patients had AC or not. Patients were followed for 1 year.
Results: A total of 484 patients were included in the analysis. The population was elderly (median 86 years) and 49% were women CA was present in 23.8 % of the included patients. In the CA group, there was a lower prevalence of diabetes mellitus and valvular disease. At one year of follow-up, mortality was significantly more frequent in patients with CA compared to those without (33.0 vs.14.9%, p < 0.001). However, there were no differences between both groups in visits to the emergency room or readmissions. In the multivariate analysis, the variables that were shown to predict all-cause mortality at one year of follow-up were chronic kidney disease (HR 1.75 (1.01-3.05) p 0.045), NT-proBNP levels (HR 2.51 (1.46-4.30) p < 0.001), confusion (HR 2.05 (1.01-4.17), p 0.048), and the presence of CA (HR 1.77 (1.11-2.84), p 0.017).
Conclusion: The presence of CA in elderly patients with HF is related to a worse prognosis at one year of follow-up. Early diagnosis of the pathology and multidisciplinary management can help improve patient outcomes.
(Copyright © 2024 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)
Databáze: MEDLINE
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