Evidence map›Paper›PMID 42485712›Full record

ArticleJACC. Advances2026

Delayed Diagnosis of Transthyretin Cardiac Amyloidosis Is Associated With Heart Failure Hospitalizations and Mortality.

Gabriela Spencer-Bonilla, Jun Fan, Anubodh Sunny Varshney, Paul Cheng, Natasha Din, Fatima Rodriguez, Marie Davies, Mia A Papas, Joanna Huang, John Venditto and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Gabriela Spencer-BonillaStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
Jun FanVeteran's Affairs Palo Alto Healthcare System, Palo Alto, California, USA.
Anubodh Sunny VarshneyStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
Paul ChengStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
Natasha DinVeteran's Affairs Palo Alto Healthcare System, Palo Alto, California, USA.
Fatima RodriguezStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
Marie DaviesU.S. Medical Affairs, BioPharmaceutical Medical, AstraZeneca, Wilmington, Delaware, USA.
Mia A PapasU.S. Medical Affairs, BioPharmaceutical Medical, AstraZeneca, Wilmington, Delaware, USA.
Joanna HuangU.S. Medical Affairs, BioPharmaceutical Medical, AstraZeneca, Wilmington, Delaware, USA.
John VendittoU.S. Medical Affairs, BioPharmaceutical Medical, AstraZeneca, Wilmington, Delaware, USA.
Ronald M WittelesStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
Paul HeidenreichStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA; Veteran's Affairs Palo Alto Healthcare System, Palo Alto, California, USA.
Kevin AlexanderStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
Alexander T SandhuDivision of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA; Greater Los Angeles VA Healthcare System, Los Angeles, California, USA. Electronic address: atsandhu@mednet.ucla.edu.

Funding

Toward Equity in ATTR Cardiomyopathy DiagnosisF32HL176160 · NHLBI · STANFORD UNIVERSITY · PI SPENCER BONILLA, GABRIELA M. · 2024 to 2024
$84k
NHLBI NIH HHS F32 HL176160
6 · The paper itself

Abstract

backgroundTransthyretin cardiac amyloidosis (ATTR-CM) is a progressive, underdiagnosed cause of heart failure (HF). Diagnostic delays may increase cardiac injury at treatment initiation, but the relationship between delay and outcomes remains poorly defined.

objectivesThe purpose of this study was to evaluate time from HF diagnosis to ATTR-CM diagnosis as a proxy for disease progression and its association with HF hospitalization (HFH) and mortality.

methodsThis retrospective cohort study used Medicare fee-for-service and Veterans Health Administration (VHA) data. We identified patients diagnosed with ATTR-CM between 2016 and 2022 using a validated algorithm based on diagnoses and medications. Time-to-diagnosis was defined as days between each patient's first HF diagnosis and first amyloid diagnosis. Using multivariable Cox models, we evaluated its association with death or HFH.

resultsWe identified 7,770 Medicare beneficiaries and 2,557 Veterans with HF and ATTR-CM. Median age at diagnosis was 81 years in both cohorts (Medicare IQR: 76-86; VHA IQR: 74-87); women comprised 1,775 (22.8%) of Medicare and 13 (0.5%) of VHA patients. Median time-to-diagnosis was 494 days (IQR: 63-1,340) for Medicare and 490 days (IQR: 69-1,286) for VHA. After adjustment for sociodemographics, each 1-year delay was associated with a 7% increased risk of the primary outcome (Medicare HR: 1.07; 95% CI: 1.06-1.08; VHA HR: 1.07; 95% CI: 1.05-1.09). Results were similar after adjusting for comorbidities.

conclusionsAcross 2 real-world populations, diagnostic delay in ATTR-CM is a clinically meaningful marker of disease progression, with longer delays associated with increased HFH and mortality.

Indexed as

amyloidosiscardiomyopathydiagnostic delaytransthyretin

Identifiers

PMID42485712
PMCPMC13425842

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.