Cardiovascular Disease and Mortality in Black Women Carrying the Amyloidogenic V122I Transthyretin Gene Variant

doi:10.1016/j.jchf.2023.02.003

Heart failure & cardiomyopathies

Cardiovascular Disease and Mortality in Black Women Carrying the Amyloidogenic V122I Transthyretin Gene Variant

JACC Heart FailPublished 5 Mar 2023Prospective cohort study

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Authors' conclusion

Black female TTR V122I (pV142I) carriers have a higher CVD and all-cause mortality risk compared to noncarriers.

Study context

Population: Generally healthy postmenopausal non-Hispanic Black/African American women, Women's Health Initiative, 40 US centres, enrolled 1993–1998
Participants: 9,862 women

Exposure: The transthyretin (TTR) V122I carriers vs noncarriers
Carriersn = 333
Noncarriersn = 9,529reference
Outcome: Composite CVD (CHD, stroke, acute HF or CVD death) and all-cause mortality
Follow-up: Mean 16.1 years (IQR: 9.7-22.2 years)

Methodological detailsmulticentre, cardiovascular disease (CVD) cases self-reported, centrally adjudicated by trained physicians

Multicentre
CVD cases self-reported, centrally adjudicated by trained physicians

Main finding

As reported in the abstract

Carriers

Incident CVD: 96
Deaths: 108

Noncarriers

Incident CVD: 2,229
Deaths: 2,689

Incident CVD

Carriers96

Noncarriers2,229

Deaths

Carriers108

Noncarriers2,689

Carriers vs NoncarriersHazard ratio (95% CI)

Composite CVD

1.52(1.22–1.88)

All-cause mortality

1.28(1.04–1.56)

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk with carriers ←→ Higher risk with carriers →	HR (95% CI)
CVD components — Carriers vs Noncarriers · acute HF	0.20.5125	2.21 (1.53–3.18)
CVD components — Carriers vs Noncarriers · CHD	0.20.5125	1.80 (1.30–2.47)
CVD components — Carriers vs Noncarriers · CVD death	0.20.5125	1.70 (1.26–2.30)
	0.20.5125Hazard ratio (log scale)

Variant frequency

Population frequency of TTR V122I: 3.4%

Effect modification

Significant interaction by age; none by BP, heart rate, BMI or physical activity

Original publication

Cardiovascular Disease and Mortality in Black Women Carrying the Amyloidogenic V122I Transthyretin Gene Variant. JACC Heart Fail. Published 5 March 2023. doi:10.1016/j.jchf.2023.02.003

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it