{Reference Type}: Journal Article
{Title}: Amyloidosis and 30-Day Outcomes Among Patients With Heart Failure: A Nationwide Readmissions Database Study.
{Author}: Arora S;Patil NS;Strassle PD;Qamar A;Vaduganathan M;Fatima A;Mogili K;Garipalli D;Grodin JL;Vavalle JP;Fonarow GC;Bhatt DL;Pandey A;
{Journal}: JACC CardioOncol
{Volume}: 2
{Issue}: 5
{Year}: Dec 2020
{Factor}: 8.422
{DOI}: 10.1016/j.jaccao.2020.10.007
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>We investigated the prevalence and prognostic implications of amyloidosis among patients hospitalized with HF.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>In patients hospitalized with decompensated HF, presence of amyloidosis was associated with higher risk of inpatient mortality and 30-day readmission.