Heart failure & cardiomyopathies
Prognostic Value of Malnutrition, Frailty, and Physical Performance in Transthyretin Cardiac Amyloidosis: Insights From a Prospective Multicenter Cohort Study
Authors' conclusion
In a national prospective cohort of patients with transthyretin cardiac amyloidosis, older age was associated with lower prescription of disease modifiers, even among individuals with a low burden of geriatric syndromes. However, when adjusted for geriatric domains, age was not associated with survival, indicating potential ageism. Because some geriatric syndromes may be modifiable, a CGA could enhance risk stratification, reduce age-related bias, and improve outcomes.
Study context
- Population
- Patients diagnosed with transthyretin cardiac amyloidosis from March 2021 to March 2024 who underwent comprehensive geriatric assessment (CGA)
- Participants
- 256 patients
- Exposure
- CGA domains (disability, malnutrition, depression, frailty, Short Physical Performance Battery, cumulative deficits) and age, in association with disease-modifying therapy and overall mortality
- Outcome
- Baseline characteristics
Main finding
As reported in the abstract
Median age
82 years
Men
n=223
87%
Variant
n=19
7.4%
Patients received disease modifiers
129
50.3%
Observational data: associations, not effects.
Further findings
Receipt of disease-modifying therapy, age ≥85 years
- Those ≥85 years had significantly lower odds of receiving disease-modifying therapy even after adjusting for disability, frailty, and cumulative deficits
Overall mortality · 1.9 (interquartile range, 1.0-2.3) years
- Patients died
- 45 (17.6%)
- CGA domains of disability, malnutrition, Short Physical Performance Battery, frailty, and number of deficits, but not age, were significantly associated with mortality
- After adjustment for National Amyloidosis Centre stage, diuretics and disease modifiers
Prognostic accuracy
- Assessment of CGA domains improved National Amyloidosis Centre prognostic accuracy
Original publication
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