Amyloidosis and 30-Day Outcomes Among Patients With Heart Failure: A Nationwide Readmissions Database Study

Sameer Arora, Nikita S. Patil, Paula D. Strassle, Arman Qamar, Muthiah Vaduganathan, Amber Fatima, Kalyan Mogili, Deepak Garipalli, Justin L. Grodin, John P. Vavalle, Gregg C. Fonarow, Deepak L. Bhatt, Ambarish Pandey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The burden of amyloidosis among hospitalized patients is increasing over time. However, amyloidosis remains an underdiagnosed cause of heart failure (HF) hospitalization among older adults. Objectives: We investigated the prevalence and prognostic implications of amyloidosis among patients hospitalized with HF. Methods: All hospitalizations for primary diagnosis of HF between January 1, 2010, and August 31, 2015, identified in the Nationwide Readmissions Database were categorized into those with and without a secondary diagnosis of amyloidosis. HF hospitalizations with amyloidosis were then matched in a 3:1 fashion to HF hospitalizations without amyloidosis using the year of admission, discharge quarter, age, sex, and Charlson comorbidity index. Primary outcomes were inpatient mortality and 30-day readmission. Multivariable logistic regression was used to estimate the association between HF with amyloidosis and clinical outcomes. Results: Of 1,593,360 HF hospitalizations that met inclusion criteria, 2,846 (0.18%) had HF with a secondary diagnosis of amyloidosis and were matched to 8,515 hospitalizations for HF without amyloidosis. Hospitalizations for HF with amyloidosis were associated with higher prevalence of kidney disease (56% vs. 45%), malignancy (20% vs. 4%), and higher inpatient mortality (6% vs. 3%) as compared with HF without amyloidosis. In adjusted analyses, HF with amyloidosis was associated with higher odds of in-hospital mortality (odds ratio: 1.46; 95% confidence interval [CI]: 1.17 to 1.82), 30-day readmission (odds ratio: 1.17; 95% CI: 1.05 to 1.31), and longer mean length of stay (least-squares mean difference: 1.46; 95% CI: 1.12 to 1.80). Conclusions: In patients hospitalized with decompensated HF, presence of amyloidosis was associated with higher risk of inpatient mortality and 30-day readmission.

Original languageEnglish (US)
Pages (from-to)710-718
Number of pages9
JournalJACC: CardioOncology
Volume2
Issue number5
DOIs
StatePublished - Dec 2020

Keywords

  • amyloidosis
  • heart failure
  • mortality
  • readmissions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Oncology

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