Impact of Arrhythmias on Hospitalizations in Patients With Cardiac Amyloidosis
Section snippets
Methods
A population-based sample of 5,585 CA related hospitalizations in patients aged >18 with or without arrhythmias was analyzed in a retrospective manner from 2016 to 2017 using the National inpatient sample (NIS) database (Figure 1). The NIS is the largest publicly available all-payer inpatient care database in the United States. Weighted, it estimates data on more than 35 million hospital stays nationally. It was set in motion by the Healthcare Cost and Utilization Project (HCUP) through a
Results
A total of 5,585 hospital admissions with CA were included in the analysis (Figure 1). Among this cohort, 2,020 (36.1%) had concurrent arrhythmia compared with 3,565 (63.8%), who had no concurrent arrhythmias. CA hospitalizations were more common in older patients(>75 years, 54.5% in CA with arrhythmia and 41.6% CA without arrhythmia, p <0.0001), Caucasians (65.2% in CA with arrhythmia and 64.3% CA without arrhythmia, p <0.0001), and those on Medicare (77.2% vs 70.1%, p <0.0001). Similar
Discussion
Our analysis of 5,585 hospitalizations with CA revealed the following findings; (1) Arrhythmias in patients with CA hospitalizations were associated with increased in-hospital mortality, acute heart failure exacerbations, increased length of stay, and hospitalization costs; (2) AF was identified as the most frequent arrhythmia among hospitalizations with CA.
An increased prevalence of AF among patients with CA echoes trends observed in previous observational studies, particularly among elderly
Credit Author Statement
Thakkar: Conceptualization; Methodology; Visualization; Writing- Original draft preparation. Patel: Conceptualization; Methodology; Software; Writing- Original draft preparation. Chowdhury: Conceptualization; Methodology; Writing- Original draft preparation. Patel: Methodology; Software. Kumar: Methodology; Software; Validation; Writing- Reviewing and Editing. Arora: Conceptualization; Methodology. Zahid: Conceptualization. Goel: Conceptualization. Barssoum: Conceptualization. Jain:
Disclosures
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
References (24)
- et al.
Arrhythmias in cardiac amyloidosis: challenges in risk stratification and treatment
Can J Cardiol
(2020) - et al.
Natural history of wild-type transthyretin cardiac amyloidosis and risk stratification using a novel staging system
J Am Coll Cardiol
(2016) - et al.
Atrial fibrillation in transthyretin cardiac amyloidosis: predictors, prevalence, and efficacy of rhythm control strategies
JACC Clin Electrophysiol
(2020) - et al.
Cardiac arrhythmias in systemic amyloidosis: correlation with echocardiographic abnormalities
J Am Coll Cardiol
(1984) - et al.
Comparison of management and outcomes of acute heart failure hospitalization in medicaid beneficiaries versus privately insured individuals
Am J Cardiol
(2020) - et al.
Worsening of congestive heart failure in amyloid heart disease treated by calcium channel-blocking agents
Am J Cardiol
(1985) - et al.
AL (light-chain) cardiac amyloidosis: a review of diagnosis and therapy
J Am Coll Cardiol
(2016) - et al.
Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction. Results From the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) program
J Am Coll Cardiol
(2006) - et al.
Natural history and therapy of AL cardiac amyloidosis
Heart Fail Rev
(2015) - et al.
Adherence to methodological standards in research using the national inpatient sample
JAMA
(2017)
Atrial fibrillation and subtype of atrial fibrillation in cardiac amyloidosis: clinical and echocardiographic features, impact on mortality
Amyloid
Atrial amyloidosis: an arrhythmogenic substrate for persistent atrial fibrillation
Circulation
Cited by (18)
Ethnic/racial differences in risk factors and clinical outcomes among patients with amyloidosis
2023, American Journal of the Medical SciencesCitation Excerpt :Around 2,000 new cases of AL amyloidosis occur in the US per year with approximately half having significant cardiac involvement.15–17 Cardiac infiltration with AL or ATTR subtypes typically manifests with symptoms of heart failure and/or arrhythmias with some patients presenting with atrioventricular (AV) block, restrictive cardiomyopathy, and heart failure.5,6,12 The burden of cardiac involvement is the main prognostic factor in patients with AL amyloidosis, being the most important predictor of the treatment outcome and overall survival.8,18
Conduction system disease in cardiac amyloidosis
2023, Trends in Cardiovascular MedicineTemporal Trends and Sex Differences in Patients With Cardiac Amyloidosis and Heart Failure With Preserved Ejection Fraction: Retrospective Analysis of 22,015 Admissions From the National Inpatient Sample
2023, Current Problems in CardiologyCitation Excerpt :Hospitalizations with a secondary diagnosis of cardiac amyloidosis were identified using ICD-10-CM codes (E85.4). A similar methodology for the identification of patients with cardiac amyloidosis was reported in literature.10 ( Fig 1).
Retrospective analyses of factors influencing arrhythmias and the impact of arrhythmias on inpatient outcomes among hospitalized patients with hemochromatosis
2022, International Journal of CardiologyCitation Excerpt :This finding is similar to a recent study that found a higher claim cost for patients diagnosed with hemochromatosis compared to patients without diagnosis [26]. The higher inpatient mortality seen are similar to reports from other studies conducted on patients with other infiltrative cardiac conditions such as sarcoidosis and cardiac amyloidosis [16,19,27]. Ventricular fibrillation, though treatable, requires early detection and treatment with external electrical defibrillation.
The Impact of Atrial Fibrillation on hospitalization Outcomes for Patients With Chronic Lymphocytic Leukemia Using the National Inpatient Sample Database
2022, Clinical Lymphoma, Myeloma and Leukemia
Funding Source: None.
- #
Thakkar and Patel contributed equally to this manuscript as co-first authors.