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<p>Although Afro-Caribbean (AC) race has been associated with worse outcomes in many cardiovascular diseases, its potential association with transthyretin cardiac amyloidosis (ATTR-CA) is less understood. We aimed to assess the relationship between race and serum biomarkers, adverse cardiac remodeling, and outcomes in AC vs white ATTR-CA patients. 114 AC and 117 white patients confirmed ATTR-CA who underwent cardiac magnetic resonance (CMR) exam were identified. The relationship between race and the primary endpoint—defined by all-cause mortality or heart failure hospitalization—was assessed using Cox regression analysis. ATTR disease stage was significantly higher at diagnosis in AC vs white patients (p &lt; 0.0001). Left (p = 0.001) and right ventricular ejection fractions (p = 0.0002) were lower and extracellular volume (58% vs 50%) higher in AC vs white patients. At a median follow up time of 365 (IQR, 97–879) days, 44% of patients had experienced the primary endpoint. AC race was strongly associated with the primary endpoint compared with White patients (HR 2.83, 95% CI 1.92–4.23, p &lt; 0.0001). AC patients were found to be at more advanced disease stages at the time of ATTR-CA diagnosis and experienced poor outcomes more frequently, highlighting the need for targeted strategies to address these health inequities.</p>

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Disparities in diagnosis and outcomes in American patients with transthyretin cardiac amyloidosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月5日

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  • Joyce L. Ngouchet Nouhossi,
  • Iva Minga,
  • Teodora Szasz,
  • Vien T. Truong,
  • Amber E. Johnson,
  • Edward Yang,
  • Srisha Kotlo,
  • Varun Subashchandran,
  • Frank Medina,
  • Karolina M. Zareba,
  • Akash Goyal,
  • Orlando P. Simonetti,
  • Amit R. Patel,
  • Cristiane C. Singulane,
  • Jai Singh,
  • Vidya Nadig,
  • Shaimaa Fadl,
  • Cory R. Trankle,
  • Nitasha Sarswat,
  • Hena N. Patel,
  • Victor Mor-Avi,
  • Bryan Smith,
  • Jeremy A. Slivnick

摘要

Although Afro-Caribbean (AC) race has been associated with worse outcomes in many cardiovascular diseases, its potential association with transthyretin cardiac amyloidosis (ATTR-CA) is less understood. We aimed to assess the relationship between race and serum biomarkers, adverse cardiac remodeling, and outcomes in AC vs white ATTR-CA patients. 114 AC and 117 white patients confirmed ATTR-CA who underwent cardiac magnetic resonance (CMR) exam were identified. The relationship between race and the primary endpoint—defined by all-cause mortality or heart failure hospitalization—was assessed using Cox regression analysis. ATTR disease stage was significantly higher at diagnosis in AC vs white patients (p < 0.0001). Left (p = 0.001) and right ventricular ejection fractions (p = 0.0002) were lower and extracellular volume (58% vs 50%) higher in AC vs white patients. At a median follow up time of 365 (IQR, 97–879) days, 44% of patients had experienced the primary endpoint. AC race was strongly associated with the primary endpoint compared with White patients (HR 2.83, 95% CI 1.92–4.23, p < 0.0001). AC patients were found to be at more advanced disease stages at the time of ATTR-CA diagnosis and experienced poor outcomes more frequently, highlighting the need for targeted strategies to address these health inequities.