Heart failure & cardiomyopathies

Association Between Occupational Physical Work Exposure and Wild-Type Transthyretin Cardiomyopathy

JACC AdvPublished matched general population cohort

Authors' conclusion

ATTRwt-CM was associated with greater occupational upper-body mechanical stress. While a causal relationship cannot be established due to study design, the results are hypothesis generating for the development of ATTRwt-CM. Additionally, ATTRwt-CM patients had a greater burden of orthopedic and cardiovascular comorbidities including increased cardiovascular mortality.

Study context

Population
Patients diagnosed with ATTRwt-CM between 2016 and 2023 and controls randomly selected from the Danish general population
Participants
258 vs 1,290
Exposure
Patients with ATTRwt-CM compared with a matched general population cohort
  • ATTRwt-CMn = 258
  • Controlsn = 1,290reference
Outcome
Cardiovascular and orthopedic comorbidities
Methodological detailsmatched 1:5 by age and sex, conditional Poisson regression
  • Matched 1:5 by age and sex
  • Conditional Poisson regression

Main finding

As reported in the abstract

  • ATTRwt-CM patients had a higher prevalence of cardiovascular comorbidities (atrial fibrillation and aortic stenosis) and orthopedic conditions (carpal tunnel syndrome, lumbar spinal stenosis, and lower limb arthrosis)

Observational data: associations, not effects.

Further findings

OutcomeATTRwt-CMControlsIRR (95% CI)
Agricultural employment28%8%3.35 (2.55–4.39)
Cardiovascular mortality · Three-year13%5%3.38 (1.97–5.83)
All-cause mortality · Three-year33%21%1.93 (1.48–2.50)

Upper body mechanical workload exposures

Greater upper body mechanical workload exposures were more common among patients with ATTRwt-CM than among controls

Original publication

Association Between Occupational Physical Work Exposure and Wild-Type Transthyretin Cardiomyopathy. JACC Adv. Published 23 February 2026. doi:10.1016/j.jacadv.2026.102619

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