Heart failure & cardiomyopathies
Prognostic Value of a 6-Minute Walk Test in Patients With Transthyretin Cardiac Amyloidosis
Main finding · Mortality by baseline 6MWT distanceResult — go to the resultHazard ratio 2.15 95% CI 1.85–2.50Authors' conclusion
The baseline 6MWT distance can refine risk stratification beyond traditional prognosticators. A worsening 6MWT distance can stratify disease progression and, when combined with established markers, identifies patients at the highest risk of mortality.
Study context
- Population
- Patients diagnosed with ATTR-CA at the National Amyloidosis Centre who underwent a baseline 6MWT, 2011–20231,118 with 1-year follow-up
- Participants
- 2,141 patients
- Exposure
- 6MWT distance categories
- Outcome
- All-cause mortality by baseline 6MWT distance
Methodological detailssingle-centre
- Single-centre
Main finding
Mortality by baseline 6MWT distance
Hazard ratio
2.15
95% CI 1.85–2.50
P < 0.001
6MWT <350 mvs 6MWT ≥350 m
HR 2.15 (95% CI 1.85–2.50); P < 0.001
As reported in the abstract
- Median baseline 6MWT distance, m (Q1-Q3: 250-428 m)
- 347
- Deaths per 100 person-years by quartile (longest to shortest distance)
- 6.3 vs 9.2 vs 13.6 vs 19.0; log-rank P < 0.001
- Similar risk across NAC disease stages
- P for interaction = 0.761
- Similar risk across genotypes
- P for interaction = 0.172
Observational data: associations, not effects.
Further findings
Mortality with worsening 6MWT at 1 year
| HR (95% CI) | P value | ||
|---|---|---|---|
| Absolute worsening (reduction >35 m) | 1.80 (1.51–2.15) | P < 0.001 | |
| Relative worsening (reduction >5%) | 1.89 (1.59–2.24) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
- Similar across NAC disease stages and genotypes
Mortality by number of progression markers (6MWT worsening, NT-proBNP progression, outpatient diuretic intensification)
- Deaths per 100 person-years with each incremental increase in progression markers
- 7.6 vs 13.9 vs 22.4 vs 32.9; log-rank P < 0.001
Original publication
Prognostic Value of a 6-Minute Walk Test in Patients With Transthyretin Cardiac Amyloidosis. J Am Coll Cardiol. Published 13 May 2024. doi:10.
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