Heart failure & cardiomyopathiesCohort study
Albuminuria in Transthyretin Cardiac Amyloidosis: Prevalence, Progression and Prognostic Importance
- Cohort study
Authors' conclusion
Albuminuria is common in patients with ATTR-CA, and more prevalent in those with a more severe cardiac phenotype. Albuminuria at diagnosis and a significant increase in UACR during follow-up are associated with mortality.
Study context
- Population
- Patients with transthyretin cardiac amyloidosis (ATTR-CA)
- Participants
- 1,181 patients
- Exposure
- Albuminuria vs normal urinary albumin to creatinine ratio (UACR)
- Microalbuminurian = 499
- Macroalbuminurian = 64
- Outcome
- Prevalence of albuminuria and its association with mortality
Main finding
As reported in the abstract
Albuminuria prevalence and mortality
Each group vs normal UACRHazard ratio (95% CI)P value
Microalbuminuria
1.47(1.13–1.92)
P = 0.005Macroalbuminuria
1.87(1.15–3.05)
P = 0.012Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Mortality, subgroup without hypertension, DM or CKD (n = 349) | 2.98 (1.72–5.17) | P < 0.001 | |
| Mortality by UACR change at 12 months (330 with repeat UACR) · n = 148, 44.8% | 1.84 (1.06–3.19) | P = 0.030 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Normal UACR | Microalbuminuria | Macroalbuminuria | Estimate | P value |
|---|---|---|---|---|---|
| NT-proBNP | median 1851 (IQR 997–3209) ng/L | Not reported in the abstract | Not reported in the abstract | P < 0.001 | |
| Troponin T | median 48 (IQR 34–68) ng/L | Not reported in the abstract | Not reported in the abstract | P < 0.001 | |
| Longitudinal strain (systolic function) | mean −11.6 (SD 3.8) % | Not reported in the abstract | Not reported in the abstract | P < 0.001 | |
| E/e' (diastolic function) | mean 16.4 (SD 6.7) | Not reported in the abstract | Not reported in the abstract | P < 0.001 |
- NT-proBNP: Albuminuria median 4027 (IQR 2173–6889) ng/L
- Troponin T: Albuminuria median 69 (IQR 46–101) ng/L
- Longitudinal strain (systolic function): Albuminuria mean −10.0 (SD 3.6) %
- E/e' (diastolic function): Albuminuria mean 17.5 (SD 6.4)
Original publication
Albuminuria in Transthyretin Cardiac Amyloidosis: Prevalence, Progression and Prognostic Importance. Eur J Heart Fail. Published 18 December 2023. doi:10.1002/ejhf.3094
Summarised from the published abstract; every number is checked against it