Outcomes of Acute Heart Failure in Patients with Amyloid or Sarcoid Cardiomyopathy: A 10 Year Nationwide Analysis

Abstract

Background Ischemic Cardiomyopathy is the leading cause of heart failure in the United States. Restrictive cardiomyopathy etiologies like sarcoid and amyloid are less common causes of heart failure and in hospital outcome descriptions are scant across the literature. Purpose describe the outcomes of acute heart failure exacerbations in patients with sarcoid or amyloid cardiomiopathy Methods A retrospective analysis using the 2005-2014 United States Nationwide Inpatient Sample was performed. Patients above 18 years with primary diagnosis of acute heart failure (AHF), systolic heart failure (SHF) and diastolic heart failure (DHF) were included. Secondary diagnosis of Sarcoid Cardiomyopathy (SCM) or Amyloid Cardiomyopathy (ACM) was generated. End stage renal disease patients were excluded. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay, cost of stay, shock, utilization of mechanical ventilation, acute kidney injury requiring dialysis (AKID), use of non-invasive ventilation (NIV), cardiac arrest, and short term mechanical circulatory support. Diagnoses were identified using ICD-9- CM codes . Multivariate logistic regression analysis adjusting for age, race, gender, hospital location was done using STATA 15. Results 2,821,201 patients with primary diagnosis of AHF were identified. In AHF cohort 2,893 patients had a history of ACM, corresponding to 42% patients with SHF and 58% patients with DHF. The SCM cohort was composed of 1,905 with AHF of which 83% had SHF and 17% had DHF. Mean age in ACM with AHF was 73 years. 63% were males. In the SCM, 52 % males with mean age of 53 years. ACM patients had increased mortality in the AHF(OR 2.5 p Conclusions In patients with AHF, mortality is increased in those with ACM compared to those without. SCM is associated with increased mechanical support use and development of shock