Hospitalization-based epidemiology of systemic and cardiac amyloidosis in the Veneto Region, Italy

Laura De Michieli; Giorgia Stoppa; Giulio Sinigiani; Lorenzo Previato; Giulia Lorenzoni; Alessandro Salvalaggio; Tamara Berno; Martina Perazzolo Marra; Chiara Briani; Sabino Iliceto; Annibale Biggeri; Dolores Catelan; Alberto Cipriani

doi:10.1016/j.ijcard.2024.131804

Hospitalization-based epidemiology of systemic and cardiac amyloidosis in the Veneto Region, Italy

Int J Cardiol. 2024 Apr 1:400:131804. doi: 10.1016/j.ijcard.2024.131804. Epub 2024 Jan 21.

Affiliations

¹ Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy.
² Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy; Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy.
³ Internal Medicine Unit, University Hospital of Padua, Italy.
⁴ Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy.
⁵ Padova Neuroscience Center (PNC), University of Padua, Italy; Department of Neurosciences, University of Padua, Italy.
⁶ Ematology Unit, University Hospital of Padua, Italy.
⁷ Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy; Cardiology Unit, University Hospital of Padua, Italy.
⁸ Department of Neurosciences, University of Padua, Italy.
⁹ Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Italy; Cardiology Unit, University Hospital of Padua, Italy. Electronic address: alberto.cipriani@unipd.it.

PMID: 38262481
DOI: 10.1016/j.ijcard.2024.131804

Abstract

Aim: Defining the epidemiology of systemic and cardiac amyloidosis (CA) is a contemporary challenge. The present study aimed to estimate incidence and time trends in amyloidosis-related hospitalizations (AH) in Veneto Region (5 million inhabitants, Northeastern Italy).

Methods: International Classification of Diseases (ICD-9) codes were used to identify AH in Veneto from 2010 to 2020. AH were defined as any hospitalization with a discharge summary reporting an ICD-9 code for systemic amyloidosis. Hospitalization for CA was defined as records with ICD-9 code for systemic amyloidosis and ICD-9 code for heart failure,cardiomyopathy or arrhythmia. Hospital/outpatient encounters for carpal tunnel syndrome (CTS) surgeries also were extracted. AH incidence was estimated using a buffer of 5 years.

Results: In the time range 2015-2020, the incidence rate of AH was 23.5 cases per 10⁶ (95% confidence interval, CI, 21.8; 25.3), mainly affecting patients>65 years (76.2%) and males (63.5%), with a progressively increasing trend (percent annual increase 17%, 95% CI 12; 22%). The 10 year prevalence of AH in 2020 was 124.5 per 10⁶ (95% CI 114.9; 134.8). In 2020, annual hospitalized prevalent cases of CA were about 70% of all cases (159/228), mainly patients >65 years and males. Among patients with multiple CTS surgeries, a subsequent code for cardiac disease was found in 913 after a median of 3.9 years, more frequently in men than in women (463/6.526 7.1% versus 450/11.406 3.9%).

Conclusions: In Veneto, we recorded a significantly increasing trend in the incidence of AH, with concordant increasing prevalence estimates.

Keywords: Cardiac amyloidosis; Epidemiology; Hospitalizations; Incidence; Prevalence; Systemic amyloidosis.

MeSH terms

Amyloidosis* / diagnosis
Amyloidosis* / epidemiology
Cardiomyopathies* / diagnosis
Cardiomyopathies* / epidemiology
Female
Heart Failure* / epidemiology
Hospitalization
Humans
Immunoglobulin Light-chain Amyloidosis*
Italy / epidemiology
Male