Key result
Higher NT-proBNP, NYHA class III-IV, lower cardiac output (<4 L/min), and pericardial effusion were independent predictors of 6-month mortality in patients with cardiac amyloidosis.
Observational (n=198)
Yes
In patients with cardiac amyloidosis, NYHA class, NT-proBNP, cardiac output, and pericardial effusion are independent predictors of 6-month mortality.
NYHA class, NT-proBNP, cardiac output, and pericardial effusion may aid short-term risk stratification across amyloid types; leaves open need for prospective validation before guiding practice.
The early prognosis of amyloidosis is known to depend heavily on cardiac function and may be improved by identifying patients at highest risk for adverse cardiac events. We looked for early predictors of mortality in patients with cardiac AL amyloidosis, hereditary transthyretin amyloidosis (m-TTR), or senile transthyretin amyloidosis (WT-TTR). Prospective observational study of 198 patients seen at two French university centers. NYHA class was III-IV in 31% of patients. Median (25th-75th percentile) values were 69 (60-76) years for age, 3027 (673-7155) pg•mL-1 for NT-proBNP, and 60% (48-66) for left ventricular ejection fraction. Interventricular septal thickness was greater in the m-TTR and WT-TTR groups than in the AL group (P<0.0001). NT-proBNP correlated with IVST (R=0.34; P=0.0001). The 6-month mortality rate was 24% (42 patients). The AL group had higher values for both NT-proBNP (P=0.0001) and 6-month mortality (P=0.0001). By multivariate analysis, independent predictors of 6-month mortality were higher NT-proBNP (Q4), NYHA class (III-IV), lower cardiac output (<4 L.min-1), and pericardial effusion. NYHA, NT-proBNP, cardiac output, and pericardial effusion were independent predictors of mortality in cardiac disease due to any of the three amyloidosis types. NT-proBNP values were highest in AL amyloidosis.
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Damy et al. (2015) conducted an observational in Cardiac amyloidosis (n=198). Prognostic markers (NT-proBNP, NYHA class, cardiac output, pericardial effusion) was evaluated on 6-month mortality. Higher NT-proBNP, NYHA class III-IV, lower cardiac output (<4 L/min), and pericardial effusion were independent predictors of 6-month mortality in patients with cardiac amyloidosis.
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