Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure with and Without Amyloidosis: A Nationwide Propensity-Matched Analysis

Cardiac amyloidosis (CA), an infiltrative restrictive cardiomyopathy, is a frequently underrecognized etiology of diastolic heart failure (HF). This study aimed to evaluate inpatient outcomes among patients hospitalized with decompensated diastolic HF with and without a secondary diagnosis of amyloi...

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Main Authors: Aravind Dilli Babu, Mirza Faris Ali Baig, David A. Baran, Jerry Estep, David Wolinsky, Nina Thakkar Rivera, Ram Bhutani, Harshit Narula, Prashant Chaulagain, David Snipelisky
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/12/5/190
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Summary:Cardiac amyloidosis (CA), an infiltrative restrictive cardiomyopathy, is a frequently underrecognized etiology of diastolic heart failure (HF). This study aimed to evaluate inpatient outcomes among patients hospitalized with decompensated diastolic HF with and without a secondary diagnosis of amyloidosis, utilizing data from the National Inpatient Sample (2018–2021). Among 2,444,699 patients hospitalized for decompensated diastolic HF, 9205 (0.3%) had a documented secondary diagnosis of amyloidosis. After 1:1 propensity-score matching, 1841 patients in each group were analyzed. Multivariate logistic regression revealed that the presence of amyloidosis was associated with significantly higher odds of in-hospital mortality (4.0% vs. 2.7%), cardiogenic shock (5.4% vs. 2.4%), acute kidney injury (28.3% vs. 22.0%), ventricular tachycardia (12.4% vs. 6.0%), and acute myocardial injury (9.5% vs. 6.0%) (all <i>p</i> < 0.05). Additionally, patients with amyloidosis had a longer mean length of stay (7.1 vs. 5.7 days) and higher mean hospitalization costs ($85,594 vs. $48,484, <i>p</i> < 0.05). Although the overall incidence of acute myocardial injury was elevated, subgroup analysis of ST-elevation and non–ST-elevation myocardial infarction revealed no significant differences. These findings underscore the considerable clinical and economic burden of amyloidosis in patients hospitalized with decompensated diastolic heart failure.
ISSN:2308-3425