Prognostic Value of Malnutrition, Frailty, and Physical Performance in Transthyretin Cardiac Amyloidosis: Insights From a Prospective Multicenter Cohort Study.
Observational study in Circulation. Heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2citing papers in PubMed
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1 · What the graph read from it
What it found
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2 · The registry
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5 · Who and what money
Authors and funding
26 authors.
Carlo FumagalliDepartment of Advanced Medical and Surgical Sciences, University of Campania, "Luigi Vanvitelli," Naples, Italy (C.F., C.S., R.M.).ORCID 0000-0001-7963-5049
Mattia ZampieriTuscan Regional Amyloidosis Centre, CardioThoracic and Vascular Department, (C.F., M.Z., G. Pini, A.A., M. Beltrami, F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0002-1140-134X
Roberto PrestaAOU Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Italy (R.P., M. Bo, G.D.F., F.P.).
Greta PiniTuscan Regional Amyloidosis Centre, CardioThoracic and Vascular Department, (C.F., M.Z., G. Pini, A.A., M. Beltrami, F.C.), Careggi University Hospital, Florence, Italy.ORCID 0009-0009-9525-1622
Giulia VetereDepartment of Biomedical, Metabolic and Neuroscience Sciences, University of Modena and Reggio Emilia, Italy (G.V.).ORCID 0009-0007-6301-1267
Alessia ArgiròTuscan Regional Amyloidosis Centre, CardioThoracic and Vascular Department, (C.F., M.Z., G. Pini, A.A., M. Beltrami, F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0002-6394-9948
Simone LonghiCardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna (S.L.), Italy.ORCID 0000-0002-7512-1179
Giacomo TiniCardiology Department, Clinical and Molecular Medicine Department, Sapienza University of Rome, Italy (G.T., B.M.).ORCID 0000-0001-8520-152X
Beatrice MusumeciCardiology Department, Clinical and Molecular Medicine Department, Sapienza University of Rome, Italy (G.T., B.M.).ORCID 0000-0003-4872-7981
Giuseppe LimongelliInherited and Rare Cardiovascular Disease, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Via L. Bianchi 1 c/o Monaldi Hospital, Naples, Italy (G.L., G. Palmiero, F.V.).ORCID 0000-0002-8291-9517
Giuseppe PalmieroInherited and Rare Cardiovascular Disease, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Via L. Bianchi 1 c/o Monaldi Hospital, Naples, Italy (G.L., G. Palmiero, F.V.).ORCID 0000-0002-5102-7460
Federica VerrilloInherited and Rare Cardiovascular Disease, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Via L. Bianchi 1 c/o Monaldi Hospital, Naples, Italy (G.L., G. Palmiero, F.V.).
Matteo BeltramiTuscan Regional Amyloidosis Centre, CardioThoracic and Vascular Department, (C.F., M.Z., G. Pini, A.A., M. Beltrami, F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0001-7161-3224
Mario BoAOU Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Italy (R.P., M. Bo, G.D.F., F.P.).ORCID 0000-0003-2945-0243
Gaetano De FerrariAOU Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Italy (R.P., M. Bo, G.D.F., F.P.).
Lorenzo TofaniDepartment of Statistics, Computer Science, Applications, University of Florence, Italy (L.T.).ORCID 0000-0001-9965-7667
Celestino SarduDepartment of Advanced Medical and Surgical Sciences, University of Campania, "Luigi Vanvitelli," Naples, Italy (C.F., C.S., R.M.).ORCID 0000-0001-5099-3790
Raffaele MarfellaDepartment of Advanced Medical and Surgical Sciences, University of Campania, "Luigi Vanvitelli," Naples, Italy (C.F., C.S., R.M.).ORCID 0000-0003-3960-9270
Niccolò MarchionniDepartment of Experimental and Clinical Medicine (A.U., N.M., I.O., S.F., F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0002-8101-4695
Federico PerfettoAOU Città della Salute e della Scienza, Department of Medical Sciences, University of Turin, Italy (R.P., M. Bo, G.D.F., F.P.).ORCID 0000-0003-0276-8331
Iacopo OlivottoDepartment of Experimental and Clinical Medicine (A.U., N.M., I.O., S.F., F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0003-1751-9266
Stefano FumagalliDepartment of Experimental and Clinical Medicine (A.U., N.M., I.O., S.F., F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0002-6950-3875
Mathew S MaurerCardiac Amyloidosis Program, Department of Medicine, Columbia University Irving Medical Center, Presbyterian Hospital, New York, NY (M.S.M.).ORCID 0000-0001-5400-5008
Marianna FontanaNational Amyloidosis Centre, Royal Free Hospital & University College London, United Kingdom (M.F.).ORCID 0000-0002-9233-9831
Andrea UngarDepartment of Experimental and Clinical Medicine (A.U., N.M., I.O., S.F., F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0002-8965-4523
Francesco CappelliTuscan Regional Amyloidosis Centre, CardioThoracic and Vascular Department, (C.F., M.Z., G. Pini, A.A., M. Beltrami, F.C.), Careggi University Hospital, Florence, Italy.ORCID 0000-0002-1622-0732
Funding
No grant is acknowledged in the PubMed record.
6 · The paper itself
Abstract
backgroundThe prevalence of transthyretin cardiac amyloidosis among older adults (often octogenarians) is increasing. We aimed to determine whether age and geriatric syndromes bear any impact on the management and outcomes in transthyretin cardiac amyloidosis and assess the risk of ageism.
methodsIn a prospective, multicenter cohort study, 256 patients diagnosed with transthyretin cardiac amyloidosis from March 2021 to March 2024 underwent comprehensive geriatric assessment (CGA). The study evaluated the prevalence and clinical associations of CGAs across different disease stages (National Amyloidosis Centre stage). Key CGA domains included disability, malnutrition, depression, frailty, Short Physical Performance Battery, and cumulative deficits (sum of the single CGA items). Associations of these measures with disease-modifying therapy and overall mortality were analyzed.
resultsMedian age was 82 years (men: n=223 [87%]; variant: n=19 [7.4%]); 129 (50.3%) patients received disease modifiers. Those ≥85 years had significantly lower odds of receiving disease-modifying therapy even after adjusting for disability, frailty, and cumulative deficits. Over 1.9 (interquartile range, 1.0-2.3) years, 45 (17.6%) patients died. After adjustment for National Amyloidosis Centre stage, diuretics and disease modifiers, CGA domains of disability, malnutrition, Short Physical Performance Battery, frailty, and number of deficits, but not age, were significantly associated with mortality. Assessment of CGA domains improved National Amyloidosis Centre prognostic accuracy.
conclusionsIn a national prospective cohort of patients with transthyretin cardiac amyloidosis, older age was associated with lower prescription of disease modifiers, even among individuals with a low burden of geriatric syndromes. However, when adjusted for geriatric domains, age was not associated with survival, indicating potential ageism. Because some geriatric syndromes may be modifiable, a CGA could enhance risk stratification, reduce age-related bias, and improve outcomes.
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Prognostic Value of Malnutrition, Frailty, and Physical Performance in Transthyretin Cardiac Amyloidosis: Insights From a Prospective Multicenter Cohort Study. · full record | OpenQuestion