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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