Transthyretin Cardiac Amyloidosis in Older Black and Hispanic Individuals With Heart Failure

作者：Frederick L. Ruberg, Sergio Teruya, Stephen Helmke, Dia A Smiley, Denise Fine, Damian Kurian, Farbod Raiszadeh, Tatiana Prokaeva, Brian Spencer, Sherry Wong, Shivda Pandey, William S. Blaner, Albert J. DeLuca, Lynne L. Johnson, Mona Kinkhabwala, Jay Leb, Akiva Mintz, Michael P. LaValley, Andrew J. Einstein, Elizabeth Cohn, Cesia Gallegos, Gillian Murtagh, Jeffery W. Kelly, Edward J. Miller, Mathew S. Maurer · 发表于：JAMA Cardiology · 年份：2025 · DOI：10.1001/jamacardio.2025.2948 · 被引用次数：16 · 研究领域：Amyloidosis: Diagnosis, Treatment, Outcomes、Parathyroid Disorders and Treatments、Dermatological and Skeletal Disorders

Importance: Transthyretin cardiac amyloidosis (ATTR-CA) is an underdiagnosed but treatable cause of heart failure (HF) in older individuals that occurs in the context of normal wild-type (ATTRwt-CA) or an abnormal inherited (ATTRv-CA) TTR gene variant. While the most common inherited TTR variant, V142I, occurs in 3% to 4% of self-identified Black Americans and is associated with excess morbidity and mortality, the prevalence of ATTR-CA in this at-risk population is unknown. Objective: To define the prevalence of ATTR-CA and proportions attributable to ATTRwt-CA or ATTRv-CA among older Black and Caribbean Hispanic individuals with HF. Design, Setting, and Participants: This prospective, multicenter, cross-sectional study was conducted in several major US cities (Boston, Massachusetts; New York, New York; and New Haven, Connecticut) among individuals who self-identified as Black or Caribbean Hispanic older than 60 years with HF. Participants were enrolled between May 2019 and June 2024, and data analysis was conducted from June 2024 to May 2025. Main Outcomes and Measures: ATTR-CA was determined by radionuclide imaging, with blood testing to exclude light-chain amyloidosis and genotyping to determine TTR gene variant. Echocardiographic, biochemical, physical performance, and quality-of-life data were collected. Results: Among 646 participants, median (IQR) participant age was 73 (66-80) years, 329 (50.6%) were women, 550 (85.1%) identified as Black, and 186 (28.8%) identified a...