Risks of Ventricular Tachyarrhythmia and Mortality in Patients with Amyloidosis A Long-Term Cohort Study

Yun Yu Chen, Ming Jen Kuo, Fa Po Chung, Yenn Jiang Lin*, Kuo Liong Chien, Yu Cheng Hsieh, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Tze Fan Chao, Jo Nan Liao, Ting Yung Chang, Chin Yu Lin, Ling Kuo, Ta Chuan Tuan, Cheng I. Wu, Chih Min Liu, Shin Huei Liu, Cheng Hung Li, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The presence of ventricular tachycardia (VT) is associated with higher mortality. The annual incidence of VT after a diagnosis of amyloidosis and the associated cardiovascular (CV) outcomes have not been well assessed in a large cohort. Methods: A total of 12,139amyloidosis patients were identified from the Taiwan National Health Insurance Research Database. Non-amyloidosis group was matched 1:1 for age, gender, hypertension, and diabetes mellitus (DM) to the amyloidosis group using a propensity score. Analysis of the risk of CV outcomes was conducted. We also analyzed the incidence of cardiac amyloidosis (CA). Results: The incidence rates of amyloidosis and CA were 6.54 and 0.61 per 100,000 person-years, respectively. Multivariable analysis revealed that the risk of VT was higher in both the amyloidosis [hazard ratio (HR): 7.90; 95% confidence interval (CI): 4.49-13.9] and CA (HR: 153.3, 95% CI: 54.3-432.7) groups. In the amyloidosis group, the risk of heart failure (HF)-related hospitalization, CV death, and all-cause death was also higher. Amyloidosis was associated with a higher CV mortality rate followingVT (HR: 1.50; 95% CI: 1.07-2.12). The onset of a new VT event in patients with amyloidosis was associated with HF, DM, chronic liver disease, and anti-arrhythmic drug use. Conclusions: In this nationwide cohort study, the incidence rates of amyloidosis and CA were 6.54 and 0.61 per 100,000 person-years, respectively. The long-term risks of VT and CV mortality were higher in the patients with amyloidosis and CA. The patients with amyloidosis had a poorer prognosis following VT events, highlighting the importance of continuous monitoring in these patients.

Original languageEnglish
Pages (from-to)464-474
Number of pages11
JournalActa Cardiologica Sinica
Volume38
Issue number4
DOIs
StatePublished - Jul 2022

Keywords

  • Amyloidosis
  • Cardiomyopathy
  • Cardiovascular death
  • Ventricular tachyarrhythmia

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