Language
English
Publication Date
3-1-2026
Journal
JACC: Advances
DOI
10.1016/j.jacadv.2026.102627
PMID
41906605
Abstract
Background: The influence of sex on the extent of missed opportunities for early diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) has not been characterized.
Objectives: The objective of the study was to determine the rate and causes of hospitalization preceding the index admission with ATTR-CM, stratifying analyses according to sex.
Methods: We conducted a retrospective cohort study of the National Readmissions Database to evaluate the 6-month hospitalizations preceding an index admission with a diagnosis of ATTR-CM.
Results: Between 2018 and 2020, there were 10,975 patients hospitalized with ATTR-CM of whom 4,545 (41.1%) had 1 or more hospital admission within the preceding 6 months. Factors associated with an increased risk of previous admission included female sex (OR: 1.39; 95% CI: 1.14-1.69; P = 0.001) and hypertension (OR: 1.40; 95% CI: 1.04-1.88; P = 0.026). Females hospitalized with ATTR-CM were more likely to have a lower financial income based on zip code quartiles. The most common primary diagnoses for the preceding 6-month admissions before hospitalization with ATTR-CM were hypertensive heart disease with or without renal disease (32.5%), sepsis (4.9%), atrial fibrillation/flutter (4.1%), and heart failure (3.6%). A previous 6-month hospitalization was associated with a 2-fold increased risk of mortality during the index admission with ATTR-CM (OR: 2.06; 95% CI: 1.32-3.20; P = 0.001).
Conclusions: Hospitalization occurs in nearly half of all patients in the 6 months before their admission with a diagnosis of ATTR-CM. The most common reasons for prior hospitalization include hypertensive heart and chronic kidney disease, sepsis, atrial arrhythmia, and heart failure. Previous hospitalization is more common among females and in the overall population is associated with a 2-fold increase in mortality.
Keywords
hospitalization, hypertensive heart disease, mortality, transthyretin amyloid cardiomyopathy
Published Open-Access
yes
Recommended Citation
Kwok, Chun Shing; Qureshi, Adnan I; Steeds, Richard P; et al., "Sex Differences in Hospitalizations in the 6 Months Before a Diagnosis of Transthyretin Amyloid Cardiomyopathy" (2026). Faculty, Staff and Students Publications. 6817.
https://digitalcommons.library.tmc.edu/baylor_docs/6817
Graphical Abstract