Clinical outcomes and disease burden in amyloidosis patients with and without atrial fibrillation⇔insight from the national inpatient sample database

Shakeel Jamal, Asim Kichloo, Beth Bailey, Jagmeet Singh, Hafeez Virk, Ronak Soni, Farah Wani, Muhammad Ajmal, Sindhura Ananthaneni, Ehizogie Edigin, Rajeev Sudhakar, Khalil Kanjwal

Research output: Contribution to journalArticlepeer-review

Abstract

Amyloidosis is a systemic illness that affects multiple organ systems, including the cardiovascular, renal, gastrointestinal, and pulmonary systems. Common manifestations include restrictive cardiomyopathy, arrhythmias, nephrotic syndrome, and gastrointestinal hemorrhage. It is unknown whether coexisting atrial fibrillation (AF) worsens the disease burden and outcomes in patients with systemic amyloidosis. In this study, those with a diagnosis of amyloidosis with and without coexisting AF were identified by querying the Healthcare Cost and Utilization Project—specifically, the National Inpatient Sample for the year 2016—based on International Classification of Diseases, 10th Revision, Clinical Modification codes. During 2016, a total of 2,997 patients were admitted with a diagnosis of amyloidosis, including 918 with concurrent AF. Greater rates of mortality (7.4% vs. 5.6%); heart block (6.8% vs. 2.8%); cardiogenic shock (5% vs. 1.6%); placement of an implantable cardioverter-defibrillator, cardiac resynchronization therapy device, or permanent pacemaker (14.5% vs. 4.5%); renal failure (29% vs. 21%); heart failure (66% vs. 30%); and bleeding complications (5.7% vs. 2.8%) were observed in patients with a diagnosis of amyloidosis and coexisting AF when compared with in patients without AF. Interestingly, patients with amyloidosis without comorbid AF had greater odds of associated stroke relative to those with concurrent AF (7.9% vs. 3.4%).

Original languageEnglish
Pages (from-to)4542-4549
Number of pages8
JournalJournal of Innovations in Cardiac Rhythm Management
Volume12
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • Amyloidosis
  • Atrial fibrillation
  • Disease burden
  • National Inpatient Sample

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