Phenotype and prognostic factors in geriatric and non‐geriatric patients with transthyretin cardiomyopathy Article Swipe
Eugenia Volpentesta
,
Mounira Kharoubi
,
Cristiano Donadio
,
Kahina Rebiai
,
Pascale Fanen
,
Benoît Funalot
,
Thierry Gendre
,
Vincent Audard
,
Florence Canouï‐Poitrine
,
Emmanuel Itti
,
Emmanuel Teíger
,
Violaine Planté‐Bordeneuve
,
Silvia Oghina
,
Denis Tixier
,
S. Mallet
,
Amaury Broussier
,
Thibaud Damy
,
Amira Zaroui
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1002/ehf2.14793
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1002/ehf2.14793
Aims Transthyretin cardiac amyloidosis (ATTR‐CM) may be an underestimated cause of heart failure among geriatric patients and represent a unique phenotype and prognostic profile. Methods and results This retrospective, observational, cohort study characterizes cardiac and extracardiac disorders at diagnosis and assesses prognosis among ATTR‐CM patients based on age (geriatric vs. non‐geriatric) and amyloidosis subtype (wild type, ATTRwt and hereditary, ATTRv). In total, 943 patients with ATTR‐CM were included, of which 306 had ATTRv and 637 had ATTRwt. Among these, 331 (35.1%) were non‐geriatric (<75 years), and 612 (64.9%) were geriatric (≥75 years). The population exhibited conduction abnormalities, atrial fibrillation and ischaemic heart disease that progressively deteriorated with age. Among ATTRwt patients, peripheral neuropathy, neurovegetative symptoms, and hearing loss were present across all age groups, but reports of carpal tunnel symptoms or surgery decreased with age. Conversely, among ATTRv patients, reports of extracardiac symptoms increased with age and Val122ILe mutation was highly prevalent among geriatric patients. The 3‐year survival was higher among non‐geriatric ATTR‐CM patients (76%) than geriatric patients (55%) and predictors of 3‐year mortality differed. Notably, predictors identified among geriatric patients were alkaline phosphatase (ALP) (HR = 1.004, 95% CI: [0.001–1.100)], troponin T hs (HR = 1.005, 95% CI: [1.001–1.120)] and tricuspid insufficiency (HR = 1.194, 95% CI: [1.02–1.230)]. Whereas, among non‐geriatric patients, NT‐proBNP (HR = 1.002, 95% CI: [1.02–1.04], global longitudinal strain (HR = 0.95, 95% CI: [0.922–0.989], and glomerular filtration rate (HR = 0.984, 95% CI: [0.968–1.00) were identified. We propose a 3‐stage prognostic staging system combining troponin T hs (≥44 ng/L) and ALP levels (≥119 UI/L). In the geriatric population, this model discriminated survival more precisely than the National Amyloidosis Centre staging, particularly for classifying between stage 1 (82%), stage 2 (50%) and stage 3 (32%) for ATTRv and ATTRwt. Conclusions These diagnostic and prognostic indicators, along with ATTR subtype, highlight the distinct characteristics of this important, geriatric ATTR‐CM patient group. Recognizing these mortality markers can be valuable for geriatricians to improve the prognostic quality management of geriatric patients with ATTR‐CM.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/ehf2.14793
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14793
- OA Status
- gold
- Cited By
- 3
- References
- 42
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4400790528
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Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4400790528Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1002/ehf2.14793Digital Object Identifier
- Title
-
Phenotype and prognostic factors in geriatric and non‐geriatric patients with transthyretin cardiomyopathyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-07-17Full publication date if available
- Authors
-
Eugenia Volpentesta, Mounira Kharoubi, Cristiano Donadio, Kahina Rebiai, Pascale Fanen, Benoît Funalot, Thierry Gendre, Vincent Audard, Florence Canouï‐Poitrine, Emmanuel Itti, Emmanuel Teíger, Violaine Planté‐Bordeneuve, Silvia Oghina, Denis Tixier, S. Mallet, Amaury Broussier, Thibaud Damy, Amira ZarouiList of authors in order
- Landing page
-
https://doi.org/10.1002/ehf2.14793Publisher landing page
- PDF URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14793Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14793Direct OA link when available
- Concepts
-
Transthyretin, Medicine, Heart failure, Phenotype, Cardiac amyloidosis, Cardiomyopathy, Amyloidosis, Internal medicine, Cardiology, Genetics, Gene, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
3Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 2, 2024: 1Per-year citation counts (last 5 years)
- References (count)
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42Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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