Quantify Research AB, Stockholm, 112 21, Sweden.
Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
ESC Heart Fail. 2022 Jun;9(3):1636-1642. doi: 10.1002/ehf2.13913. Epub 2022 Apr 1.
Transthyretin amyloid cardiomyopathy (ATTR-CM) is the cardiac manifestation of transthyretin amyloidosis (ATTR). The aim of this study was to estimate healthcare resource use for ATTR-CM patients compared with heart failure (HF) patients, in Denmark, Finland, Norway, and Sweden.
Data from nationwide healthcare registers in the four countries were used. ATTR-CM patients were defined as individuals diagnosed with amyloidosis and cardiomyopathy or HF between 2008 and 2018. Patients in the ATTR-CM cohort were matched to patients with HF but without ATTR-CM diagnosis. Resource use included number of visits to specialty outpatient and inpatient hospital care. A total of 1831 ATTR-CM and 1831 HF patients were included in the analysis. The mean number of hospital-based healthcare contacts increased in both the ATTR-CM and HF cohort during 3 years pre-diagnosis and was consistently higher for the ATTR-CM cohort compared with the HF cohort, with 6.1 [CI: 5.9-6.3] vs. 3.2 [CI: 3.1-3.3] outpatient visits and 1.03 [CI: 0.96-1.1] vs. 0.7 [CI: 0.7-0.8] hospitalizations. In the first year following diagnosis, patients with ATTR-CM continued to visit outpatient care (10.2 [CI: 10.1, 10.4] vs. 5.7 [CI: 5.6, 5.9]) and were admitted to hospital more frequently (3.3 [CI: 3.2, 3.4] vs. 2.5 [CI: 2.5, 2.6]) than HF patients.
Transthyretin amyloid cardiomyopathy imposes a high burden on healthcare systems with twice as many outpatient specialist visits and 50% more hospitalizations in the year after diagnosis compared with HF patients without ATTR-CM. Studies to investigate if earlier diagnosis and treatment of ATTR-CM may lower resource use are warranted.
转甲状腺素蛋白淀粉样心肌病（ATTR-CM）是转甲状腺素蛋白淀粉样变性（ATTR）的心脏表现。本研究旨在评估丹麦、芬兰、挪威和瑞典的 ATTR-CM 患者与心力衰竭（HF）患者相比的医疗资源使用情况。
使用了这四个国家的全国性医疗保健登记处的数据。ATTR-CM 患者被定义为 2008 年至 2018 年间诊断为淀粉样变性和心肌病或 HF 的个体。ATTR-CM 队列中的患者与无 ATTR-CM 诊断的 HF 患者相匹配。资源使用包括专科门诊和住院医院治疗的就诊次数。共纳入 1831 例 ATTR-CM 和 1831 例 HF 患者进行分析。在诊断前 3 年，ATTR-CM 和 HF 队列中的住院医疗接触次数均增加，并且 ATTR-CM 队列的接触次数始终高于 HF 队列，分别为 6.1[CI：5.9-6.3]次和 3.2[CI：3.1-3.3]次门诊就诊和 1.03[CI：0.96-1.1]次和 0.7[CI：0.7-0.8]次住院治疗。在诊断后的第一年，ATTR-CM 患者继续接受门诊治疗（10.2[CI：10.1，10.4] vs. 5.7[CI：5.6，5.9]），并且住院治疗更频繁（3.3[CI：3.2，3.4] vs. 2.5[CI：2.5，2.6]）与 HF 患者相比。
转甲状腺素蛋白淀粉样心肌病对医疗系统造成了沉重负担，与无 ATTR-CM 的 HF 患者相比，在诊断后 1 年内，门诊专科就诊次数增加了一倍，住院次数增加了 50%。需要进行研究以探讨是否更早诊断和治疗 ATTR-CM 可以降低资源使用。
