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

Ruiz Hueso, R. ; Salamanca Bautista, P. ; Quesada Simón, M.A. ; Yun, S. ; Conde Martel, A. ; Morales Rull, J.L. ; Fiteni Mera, I. ; Abad Pérez, D. ; Páez Rubio, I. ; Aramburu Bodas, Ó. ; Abad Pérez, D. ; Amores Arriaga, B. (Universidad de Zaragoza) ; Amorós Martínez, F. ; Andrés Imaz, N. ; Aramburu Bodas, O. ; Armengou Arxe, A. ; Bermudo Guitarte, C. ; Bernardo Galán, P. ; Bonache Bernal, F. ; Calero Molina, E. ; Calvo Morón, M.C. ; Casado Cerrada, J. ; Castillo Paredes, M. ; Cepeda Rodrigo, J.M. ; Choucino Fernández, T. ; Conde Martel, A. ; Cuadrat Begue, I. ; Delgado Verges, C. ; Díez Manglano, J. (Universidad de Zaragoza) ; Domingo Baldrich, E. ; Fernández Soler, C. ; Fiteni Mera, I. ; Fonseca Aizpuru, E.M. ; Formiga, F. ; García García, J.A. ; García-Fernández Bravo, I. ; González Moraleja, J. ; Liroa Romero, M.F. ; Llàcer Iborra, P. ; López Reboiro, M.L. ; Martínez González, A. ; Martínez Rodés, P. ; Méndez Bailón, M. ; Montero Hernández, E. ; Morales Rull, J.L. ; Moya Saiz, M.J. ; Muela Molinero, A. ; Navarro Sáez, M.C. ; Pacheco Castellanos, M.C. ; Páez Rubio, I. ; Peña Somovilla, J.L. ; Pérez Bocanegra, C. ; Quesada Simón, M.A. ; Redondo Galán, M.P. ; Ruiz Hueso, R. ; Salamanca Bautista, P. ; Sánchez Castaño, A.J. ; Seoane González, B. ; Soler Rangel, M.L. ; Soriano Sánchez, T. ; Suárez Gil, R. ; Vaquero Hernández, J.M. ; Vicente Rodrigo, J.A. ; Yun, S.

Resumen: 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.

Idioma: Inglés

DOI: 10.1016/j.rceng.2024.07.006

Año: 2024

Publicado en: Revista Clínica Española (English Edition) 224, 8 (2024), 494-502
ISSN: 2254-8874

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)