Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada; Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Patient Health Outcomes Research and Clinical Effectiveness Unit, University of Alberta, Edmonton, Alberta, Canada.
J Card Fail. 2022 Feb;28(2):237-246. doi: 10.1016/j.cardfail.2021.08.016. Epub 2021 Sep 9.
Despite the improved awareness of cardiac amyloidosis among clinicians, its incidence and prevalence is not well-described in a community setting. We sought to investigate the incidence and prevalence of cardiac amyloidosis in the community.
In the adult population of Alberta, we examined 3 cohorts: (1) probable cases of cardiac amyloidosis: the presence of physician-assigned diagnosis of amyloidosis (International Classification of Diseases [ICD]-10 code E85; ICD-9 277.3) and 1 or more health care encounter for heart failure (HF) (ICD-10 I50; ICD-9 428); (2) possible cardiac amyloidosis: the presence of clinical phenotypes suggestive of amyloidosis; and (3) a comparator HF cohort without amyloidosis. Between 2004 and 2018, 982 of the 145,329 patients with HF were identified as probable cardiac amyloidosis. During the same period, the incidence rates of probable cardiac amyloidosis increased from 1.38 to 3.69 per 100,000 person-years and the prevalence rates increased from 3.42 to 14.85 per 100,000 person-years (P < .0001). Patients with probable cardiac amyloidosis were more likely to be male, have a higher comorbidity burden, greater health care use, and poorer outcomes as compared with patients with HF without amyloidosis. A much larger group of patients was identified as possible cardiac amyloidosis (n = 46,255), with similar increase in prevalence from 2004 to 2018 (from 416 to 850 per 100,000 person-years).
The incidence and prevalence of cardiac amyloidosis has increased over the last decade. Given the advent of new therapies for cardiac amyloidosis and considering their high cost, it is imperative to devise strategies to screen, identify, and track patients with cardiac amyloidosis from administrative databases.
尽管临床医生对心脏淀粉样变性的认识有所提高，但在社区环境中，其发病率和患病率尚不清楚。我们旨在研究社区中心脏淀粉样变性的发病率和患病率。
在艾伯塔省的成年人群中，我们检查了 3 个队列：（1）心脏淀粉样变性的可能病例：存在医生诊断的淀粉样变性（国际疾病分类[ICD]-10 代码 E85；ICD-9 277.3）和 1 次或多次心力衰竭（HF）的医疗保健就诊（ICD-10 I50；ICD-9 428）；（2）可能的心脏淀粉样变性：存在提示淀粉样变性的临床表型；和（3）无淀粉样变性的对照 HF 队列。在 2004 年至 2018 年间，在 145329 例 HF 患者中发现了 982 例可能患有心脏淀粉样变性。在此期间，可能患有心脏淀粉样变性的发病率从每 100000 人年 1.38 例增加到 3.69 例，患病率从每 100000 人年 3.42 例增加到 14.85 例（P<0.0001）。与无淀粉样变性的 HF 患者相比，患有可能患有心脏淀粉样变性的患者更可能为男性，具有更高的合并症负担，更多的医疗保健使用和更差的预后。有更多的患者被诊断为可能患有心脏淀粉样变性（n=46255），患病率也从 2004 年到 2018 年相似地增加（从每 100000 人年 416 例增加到 850 例）。
过去十年中，心脏淀粉样变性的发病率和患病率有所增加。鉴于新的心脏淀粉样变性疗法的出现，并且考虑到其高昂的成本，从行政数据库中筛选，识别和跟踪心脏淀粉样变性患者的策略势在必行。
