Abstract 13090: Clinical Burden of Transthyretin Amyloid Cardiomyopathy (ATTR-CM) in the USA From 2004 to 2022

Abstract

Introduction: Advances in diagnosis and disease awareness have led to increased prevalence and incidence of diagnosed transthyretin amyloid cardiomyopathy (ATTR-CM) worldwide. At the same time, patients are being diagnosed at an older age and with multiple comorbidities. Current data on the clinical burden of ATTR-CM in the USA are lacking. Aims: To assess the clinical burden of ATTR-CM in terms of comorbidities, medication use, and healthcare resource utilization in a large US population over time. Methods: Data from 2004–2022 were extracted from TriNetX, a US database of electronic medical records covering in- and outpatient data. An algorithm using ICD-9/10 codes and RxNorm codes for clinical drugs (amyloidosis + cardiac manifestation – light chain amyloidosis) was used to identify patients with ATTR-CM. Included were adults ≥ 18 years old at index date (first ATTR-CM diagnosis per the algorithm) with ≥ 1 year of database history. Demographic characteristics at index, medication use and clinical encounters in the year pre-index, and comorbidities at any time pre-index were assessed in cross-sectional cohorts over time. Results: Of more than 78 million patients in the database, 12 209 fulfilled all inclusion criteria (2004–2008, n = 332; 2009–2013, n = 913; 2014–2018, n = 3392; 2019–2022, n = 7572). The prevalence of both ATTR-CM-related comorbidities and other comorbidities, as well as associated medication use, generally increased over time ( Table ). In the year before ATTR-CM diagnosis, a considerable proportion of patients had outpatient, inpatient and emergency visits; among patients with one or more clinical encounter, the median number of encounters (any encounter) was ≥ 10 across all cohorts ( Table ). Conclusion: In patients with ATTR-CM in this large US population, the clinical burden has become more complex over time, with an increasing proportion of patients having multiple morbidities and clinical encounters in the time before diagnosis.