Amyloidosis and 30-Day Outcomes Among Patients With Heart Failure: A Nationwide Readmissions Database Study.

Abstract

BACKGROUND:

The burden of amyloidosis among hospitalized patients is increasing over time. However, amyloidosis remains an underdiagnosed cause of heart failure (HF) hospitalization among older adults.

OBJECTIVES:

We investigated the prevalence and prognostic implications of amyloidosis among patients hospitalized with HF.

METHODS:

All hospitalizations for primary diagnosis of HF between January 1, 2010, and August 31, 2015, identified in the Nationwide Readmissions Database were categorized into those with and without a secondary diagnosis of amyloidosis. HF hospitalizations with amyloidosis were then matched in a 3:1 fashion to HF hospitalizations without amyloidosis using the year of admission, discharge quarter, age, sex, and Charlson comorbidity index. Primary outcomes were inpatient mortality and 30-day readmission. Multivariable logistic regression was used to estimate the association between HF with amyloidosis and clinical outcomes.

RESULTS:

Of 1,593,360 HF hospitalizations that met inclusion criteria, 2,846 (0.18%) had HF with a secondary diagnosis of amyloidosis and were matched to 8,515 hospitalizations for HF without amyloidosis. Hospitalizations for HF with amyloidosis were associated with higher prevalence of kidney disease (56% vs. 45%), malignancy (20% vs. 4%), and higher inpatient mortality (6% vs. 3%) as compared with HF without amyloidosis. In adjusted analyses, HF with amyloidosis was associated with higher odds of in-hospital mortality (odds ratio: 1.46; 95% confidence interval [CI]: 1.17 to 1.82), 30-day readmission (odds ratio: 1.17; 95% CI: 1.05 to 1.31), and longer mean length of stay (least-squares mean difference: 1.46; 95% CI: 1.12 to 1.80).

CONCLUSIONS:

In patients hospitalized with decompensated HF, presence of amyloidosis was associated with higher risk of inpatient mortality and 30-day readmission.

• Authors: Sameer Arora, Nikita S Patil, Paula D Strassle, Arman Qamar, Muthiah Vaduganathan, Amber Fatima, Kalyan Mogili, Deepak Garipalli, Justin L Grodin, John P Vavalle, Gregg C Fonarow, Deepak L Bhatt, Ambarish Pandey
• Journal: JACC. CardioOncology (JACC CardioOncol) Vol. 2 Issue 5 Pg. 710-718 (Dec 2020) ISSN: 2666-0873 [Electronic] United States
• PMID: 34396285 (Publication Type: Journal Article)
• Copyright: © 2020 The Authors.