Anirban Das

The prevalence of cardiac amyloidosis in the Danish population elevated in the last 2 decades, translating to a potential increase in the international population, by an analysis posted in JACC: CardioOncology.

“Cardiac amyloidosis (CA) has been associated with high 5-year mortality of 44% to 65% diagnosis. Screening studies show a higher prevalence of occult CA than formerly expected, indicating that the burden of CA is underestimated,” Oscar Westin, MD, from the Heart Center at the University Hospital of Copenhagen, Denmark, and associates wrote. “Recent advances in diagnostic modalities, such as bone tracer scintigraphy, cardiac magnetic resonance imaging, and mass spectrometry, as well as state-of-the-art pharmacotherapy have brought increased attention to identifying patients with transthyretin amyloidosis ... However, no unselected national data exist. Our objective was therefore to describe the temporal trends in a Danish population of CA patients and to examine the changes in patient characteristics over the past 2 decades.”

The researchers said that due to the fact the rising incidence of cardiac amyloidosis is mainly in elderly men, it's far likely by and large pushed through wild-type transthyretin amyloidosis. Although 2-year mortality among patients with cardiac amyloidosis reduced from 82.6% in 1998-2002 to 50.2% in 2013-2017, mortality amongst sufferers with cardiac amyloidosis remained better in comparison with the overall populace. “CA is increasingly diagnosed in Denmark, and the increasing frequency of male patients and the median age at diagnosis suggests that [wild-type transthyretin amyloidosis] is driving the increase. Greater early recognition and resultant less advanced cases might explain decreasing mortality, as the trends uncovered in this retrospective study are observed before national approval of disease-modifying drugs for [transthyretin amyloidosis],” the researchers wrote. “Future studies on clinical outcomes in CA are needed as novel disease-modifying drugs are approved for use in the treatment of both [light chain amyloidosis] and [transthyretin amyloidosis], revolutionizing the therapeutic possibilities and further drawing important attention to the disease.” “Amyloidosis is no longer rare. Physicians must think of amyloidosis early as a differential diagnosis to initiate specific confirmatory investigations or a tissue biopsy enabling early diagnosis to allow for more effective treatments and better outcomes,” Wechalekar wrote.

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