Abstract 11891: Greater Rates of Readmission and Length of Stay Among Heart Failure Patients With Cardiac Amyloidosis Than Those Without

Abstract

Introduction: Cardiac amyloidosis (CA) portends a poor prognosis in heart failure (HF) patients. While CA is being diagnosed with an increasing frequency, it is not known whether the knowledge of a diagnosis of CA influences HF readmissions or hospital length of stay (LOS). Methods: Data on HF readmission and hospital LOS was collected for patients undergoing Technetium pyrophosphate (PYP) imaging for CA between January 2018 to December 2020 from our institution’s Business Intelligence reports. CA was confirmed by a combination of PYP imaging and assessment of monoclonal proteins. Number of readmissions per patient per year and the mean cumulative LOS per year were calculated for those with and without confirmed CA. Date of confirmatory testing was used as a cut-off for comparison of HF readmission and LOS prior to and after diagnosis of CA. Results: A total of 112 patients underwent PYP imaging during the study period, of which 30 (27%) had CA (transthyretin=26; light-chain=4). Patients with CA were similar in proportion of African Americans (90%) and gender (57% women) compared to those without CA, but were older on average (76.7 vs 69.4 years, p=0.002). Patients with CA had more frequent HF readmissions prior to and after their diagnosis compared to those without CA (Figure). While both had similar LOS prior to confirmatory testing, LOS was significantly higher in CA patients following diagnosis. Patients without CA saw a significant decline in HF readmission and LOS after performance of confirmatory testing, contrasting with CA patients whose readmissions rates and LOS remained unchanged before and after confirmation of the diagnosis. Conclusions: Patients with CA have more frequent HF readmissions and a higher annual LOS when compared to those without CA. Confirmation of CA diagnosis has no effect on these outcomes. Patients with CA may require more tailored interventions to reduce their acute care healthcare utilization.