Prevalence of Orthopedic Manifestations in Patients With Cardiac Amyloidosis With a Focus on Shoulder Pathologies

Transthyretin cardiac amyloidosis (ATTR-CA) is a restrictive cardiomyopathy that has been associated with multiple orthopedic pathologies years before it manifests in the heart. There have been no studies on the prevalence of a wide range of shoulder pathologies in patients with cardiac amyloidosis...

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Bibliographic Details
Published in:The American journal of cardiology 2023-03, Vol.190, p.67-74
Main Authors: Basdavanos, Alyssa, Maurer, Mathew S., Ives, Lauren, Derwin, Kathleen, Ricchetti, Eric T., Seitz, William, Hanna, Mazen
Format: Article
Language:English
Subjects:
Age
Amyloidosis
Amyloidosis - complications
Amyloidosis - epidemiology
Arthroplasty (hip)
Arthroplasty (knee)
Biopsy
Bone surgery
Cardiomyopathies - complications
Cardiomyopathies - epidemiology
Cardiomyopathy
Carpal tunnel syndrome
Case-Control Studies
Confidence intervals
Heart
Humans
Immunoglobulin Light-chain Amyloidosis - complications
Joint replacement surgery
Orthopedics
Pathology
Patients
Prealbumin
Prevalence
Retrospective Studies
Rotator cuff
Shoulder
Soft tissues
Spinal stenosis
Tendons
Transthyretin
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Summary:Transthyretin cardiac amyloidosis (ATTR-CA) is a restrictive cardiomyopathy that has been associated with multiple orthopedic pathologies years before it manifests in the heart. There have been no studies on the prevalence of a wide range of shoulder pathologies in patients with cardiac amyloidosis (CA). Due to the preferential deposition of transthyretin in the soft tissues and joints, we predicted a greater prevalence of shoulder pathologies and other orthopedic manifestations in patients with ATTR-CA. This single-center, retrospective, case-control study, analyzed 1,310 patients with CA, 830 with ATTR-CA, and 480 with light-chain CA (AL-CA) from a dedicated CA REDcap database. Odds ratios comparing patients with CA to the age-matched published estimate of over 300 million patients in the general population were determined for shoulder, hip, and knee arthroplasty. Years between a patient's first shoulder pathology (i.e., shoulder arthroplasty) and the year of their diagnosis with CA were determined using data from patients with a known date of surgery. Overall, patients with ATTR-CA compared with patients with AL-CA presented more frequently with shoulder pathologies (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2022.11.014