Association of cardiac amyloidosis with valvular heart diseases – a nationwide analysis

Abstract

Abstract Background Association of cardiac amyloidosis (CA) with aortic stenosis (AS) is well known. There is limited data on the association of CA with other valvular heart diseases like aortic regurgitation (AR), mitral stenosis (MS), mitral regurgitation (MR), tricuspid stenosis (TS), tricuspid regurgitation (TR), pulmonary stenosis (PS) and regurgitation (PR). Purpose To assess the associations between valvular heart diseases and cardiac amyloidosis. Methods This is a retrospective observational study from hospitalizations between January 1, 2016, and December 31, 2019, using the National Inpatient Sample (NIS), the largest all-payer public database of hospital care data in the United States. We looked into associations between valvular heart diseases (VHD) and CA. Results From 2016 to 2019, a total of 4999 patients with a history of CA, 16,711 MS, 361,864 MR, 380,072 AS, 89,452 AR, 194 TS, 104,151 TR, 853 PS, 13,277 PR were identified. Compared to those without any history of CA, those with a history of CA had significantly higher associations with MR (6.4% vs 1.3%, p<0.001), AS (3.6% vs 1.3%, p<0.001), AR (1% vs 0.3%, p<0.001), TS (0.02% vs 0, p<0.033), TR (2.7% vs 0.4%, p<0.001), PR (0.4% vs 0.1%, p<0.001). Mean age of patients with history of CA in MS (73.7 years), MR (75.2 years), AS (81.4 years), AR (77.1 years), TS (82 years), TR (77.3 years), PR (78.1 years). Compared to males, females had higher incidence of MS (0.1% vs 0.03%, p<0.001) and lower incidence of AS (1.2% vs 1.6%, p<0.001) and AR (0.3% vs 0.4%, p<0.001). Conclusion There was a significantly higher association between CA and MR, AS, TR. Comparatively, patients with CA and MS were younger than those with other VHD. Funding Acknowledgement Type of funding sources: None.