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Predictors of developing renal dysfunction following diagnosis of transthyretin cardiac amyloidosis.
McDonald, Malcolm L; Manla, Yosef; Sonnino, Alice; Alonso, Mileydis; Neicheril, Radhika K; Sanchez, Alejandro; Lafave, Gabrielle; Armas, Yelenis Seijo De; Camargo, Antonio Lewis; Uppal, Dipan; Handa, Armaan; Wolinsky, David; Rivera, Nina Thakkar; Velez, Mauricio; Baran, David A; Estep, Jerry D; Snipelisky, David.
Afiliación
  • McDonald ML; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Manla Y; Department of Cardiology, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
  • Sonnino A; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Alonso M; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Neicheril RK; Department of Medicine, Internal Medicine, Cleveland Clinic Florida, Weston, Florida, USA.
  • Sanchez A; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Lafave G; Department of Cardiology, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
  • Armas YS; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Camargo AL; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Uppal D; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Handa A; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Wolinsky D; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Rivera NT; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Velez M; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Baran DA; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Estep JD; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
  • Snipelisky D; Department of Cardiovascular Disease, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA.
Clin Cardiol ; 47(6): e24298, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38873847
ABSTRACT

BACKGROUND:

In patients with transthyretin cardiac amyloidosis (ATTR-CA), renal dysfunction is a poor prognostic indicator. Limited data are available on variables that portend worsening renal function (wRF) among ATTR-CA patients.

OBJECTIVES:

This study assesses which characteristics place patients at higher risk for the development of wRF (defined as a drop of ≥10% in glomerular filtration rate [GFR]) within the first year following diagnosis of ATTR-CA.

METHODS:

We included patients with ATTR-CA (n = 134) evaluated between 2/2016 and 12/2022 and followed for up to 1 year at our amyloid clinic. Patients were stratified into two groups a group with maintained renal function (mRF) and a group with wRF and compared using appropriate testing. Significant variables in the univariate analysis were included in the multivariable logistic regression model to determine characteristics associated with wRF.

RESULTS:

Within a follow-up period of 326 ± 118 days, the median GFR% change measured -6% [-18%, +8]. About 41.8% (n = 56) had wRF, while the remainder had mRF. In addition, in patients with no prior history of chronic kidney disease (CKD), 25.5% developed de novo CKD. On multivariable logistic regression, only New York Heart Association (NYHA) class ≥III (odds ratio [OR] 3.9, 95% confidence interval [CI] [1.6-9.3]), history of ischemic heart disease (IHD) (OR 0.3, 95% CI [0.1-0.7]), and not receiving SGLT-2i (OR 0.1, 95% CI [0.02-0.5]) were significant predictors of wRF.

CONCLUSION:

Our study demonstrated that the development of de novo renal dysfunction or wRF is common following the diagnosis of ATTR-CA. Additionally, we identified worse NYHA class and no prior history of IHD as significant predictors associated with developing wRF, while receiving SGLT-2i therapy appeared to be protective in this population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuropatías Amiloides Familiares / Insuficiencia Renal Crónica Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuropatías Amiloides Familiares / Insuficiencia Renal Crónica Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos