Ethnic/racial differences in risk factors and clinical outcomes among patients with amyloidosis |
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| Institution: | 1. Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, United States;2. Biostatitsics and Epidemiology Consulting Lab (BECL), Office of Research, Texas Tech University of Health Sciences Center, El Paso, TX, United States;3. Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University of Health Sciences Center, El Paso, TX, United States;4. Department of Internal Medicine, Texas Tech University Health Sciences Center at El Paso, TX, United States;1. Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA;2. Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA;3. Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA;4. Division of Cardiology, New York Medical College—Westchester Medical Center, Valhalla, NY, USA;5. Division of Cardiovascular medicine, University of Utah, Salt Lake City, UT, USA;6. Department of Cardiology, Texas Tech University Health Sciences Center, El Paso, TX, USA;7. Department of Cardiology, Winthrop University Hospital, Mineola, NY, USA;8. Division of Cardiology, University of California, Irvine Medical Center, Orange, CA, USA;1. Temple University Hospital, Philadelphia, PA;2. University of Cyprus Medical School, Nicosia, Cyprus;1. Department of Medicine, Division of Cardiovascular Diseases, Stony Brook University Medical Center, Stony Brook, New York, United States;2. Department of Medicine, Brown University Rhode Island Hospital, Providence, RI, United States;3. Weill-Cornell Medical Center, New York, NY, United States |
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| Abstract: | BackgroundCardiac amyloidosis is caused by abnormal extracellular deposition of insoluble fibrils in cardiac tissue. It can be fatal when untreated and is often underdiagnosed. Understanding the ethnic/racial differences in risk factors is critical for early diagnosis and treatment to improve clinical outcomes.MethodsWe performed a retrospective cross-sectional study utilizing the National Inpatient Sample database from 2015 to 2018 using ICD-10-CM codes. The primary variables of interest were race/ethnicity and amyloidosis subtypes, while the primary outcomes were in-hospital mortality, gastrointestinal bleeding, renal failure, and hospital length-of-stay.ResultsAmyloidosis was reported in 0.17% of all hospitalizations (N = 19,678,415). Of these, 0.09% were non-Hispanic whites, 0.04% were non-Hispanic blacks, and 0.02% were Hispanic. Hospitalizations with ATTR amyloidosis subtype were frequently observed in older individuals and males with coronary artery disease, whereas AL amyloidosis subtype was associated with non-Hispanic whites, congestive heart failure, and longer hospital length of stay. Renal failure was associated with non-Hispanic blacks (adjusted relative risk RR] = 1.31, p < 0.001), Hispanics (RR = 1.08, p = 0.028) and had an increased risk of mortality. Similarly, the hospital length of stay was longer with non-Hispanic blacks (RR = 1.19, p < 0.001) and Hispanics (RR = 1.05, p = 0.03) compared to non-Hispanic whites. Hispanics had a reduced risk of mortality (RR = 0.77, p = 0.028) compared to non-Hispanic whites and non-Hispanic blacks, and no significant difference in mortality was seen between non-Hispanic whites and non-Hispanic blacks (RR = 1.00, p = 0.963).ConclusionsOur findings highlight significant ethnic/racial differences in risk factors and outcomes among amyloidosis-related US hospitalizations that can possibly be used for early detection, treatment, and better clinical outcomes. |
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| Keywords: | Cardiac amyloidosis |
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