Heart failure & cardiomyopathiesCohort study
Delayed Diagnosis of Transthyretin Amyloid Cardiomyopathy in the Veterans Health Administration
- Retrospective cohort study
Authors' conclusion
There are clinically important delays between incident HF and diagnosis of ATTR-CM. Carrying a diagnosis of atrial fibrillation, coronary artery disease, or chronic kidney disease was associated with a longer delay to diagnosis.
Study context
- Population
- Veterans with heart failure (HF) and ATTR-CM diagnosed 2016–2022, Veterans Health Administration
- Participants
- 2,557 veterans
- Outcome
- Time to ATTR-CM diagnosis (days from first HF diagnosis to first ATTR-CM diagnosis)
Main finding
As reported in the abstract
Median time to ATTR-CM diagnosis
490 days
Median days to diagnosis across VA sites, range
169 to 1,070 days
Observational data: associations, not effects.
Further findings
Predictors of time to diagnosis >6 months (multivariable logistic regression)
| Comparison | OR (95% CI) | |
|---|---|---|
| Black race · shorter time to diagnosis · after adjustment | 0.71 (0.57–0.88) | |
| older age · shorter time to diagnosis · after adjustment | 0.66 (0.59–0.73) | |
| atrial fibrillation · history; longer time to diagnosis · after adjustment | 1.21 (1.00–1.45) | |
| coronary artery disease · history; longer time to diagnosis · after adjustment | 1.38 (1.15–1.64) | |
| chronic kidney disease · history; longer time to diagnosis · after adjustment | 1.79 (1.50–2.15) | |
| 0.512Odds ratio (log scale) |
Time from first loop diuretic prescription to ATTR-CM diagnosis (1,882 with loop diuretic before diagnosis)
- Median time from initial loop prescription to ATTR-CM diagnosis
- 835 days (Q1-Q3: 250-1850)
Median time to diagnosis across VA sites
- Range of site medians
- 169 to 1,070 days
Original publication
Summarised from the published abstract; every number is checked against it