Matches in SemOpenAlex for { <https://semopenalex.org/work/W4308059498> ?p ?o ?g. }
- W4308059498 endingPage "1670" @default.
- W4308059498 startingPage "1657" @default.
- W4308059498 abstract "Diagnostic and therapeutic advances have led to much greater awareness of transthyretin cardiac amyloidosis (ATTR-CA). We aimed to characterize changes in the clinical phenotype of patients diagnosed with ATTR-CA over the past 20 years.This is a retrospective observational cohort study of all patients referred to the National Amyloidosis Centre (2002-2021) in whom ATTR-CA was a differential diagnosis.We identified 2995 patients referred with suspected ATTR-CA, of whom 1967 had a diagnosis of ATTR-CA confirmed. Analysis by 5-year periods revealed an incremental increase in referrals, with higher proportions of patients having been referred after bone scintigraphy and cardiac magnetic resonance imaging (2% versus 34% versus 51% versus 55%, chi-square P<0.001). This was accompanied by a greater number of ATTR-CA diagnoses, predominantly of the wild-type nonhereditary form, which is now the most commonly diagnosed form of ATTR-CA (0% versus 54% versus 67% versus 66%, chi-square P<0.001). Over time, the median duration of associated symptoms before diagnosis fell from 36 months between 2002 and 2006 to 12 months between 2017 and 2021 (Mann-Whitney P<0.001), and a greater proportion of patients had early-stage disease at diagnosis across the 5-year periods (National Amyloidosis Centre stage 1: 34% versus 42% versus 44% versus 53%, chi-square P<0.001). This was associated with more favorable echocardiographic parameters of structure and function, including lesser interventricular septal thickness (18.0±3.8 mm versus 17.2±2.6 mm versus 16.9±2.3 mm versus 16.6±2.4 mm, P=0.01) and higher left ventricular ejection fraction (46.0%±8.9% versus 46.8%±11.0% versus 47.8%±11.0% versus 49.5%±11.1%, P<0.001). Mortality decreased progressively during the study period (2007-2011 versus 2012-2016: hazard ratio, 1.57 [95% CI, 1.31-1.89], P<0.001; and 2012-2016 versus 2017-2021: hazard ratio, 1.89 [95% CI, 1.55-2.30], P<0.001). The proportion of patients enrolled into clinical trials and prescribed disease-modifying therapy increased over the 20-year period, but even when censoring at the trial or medication start date, year of diagnosis remained a significant predictor of mortality (2012-2016 versus 2017-2021: hazard ratio, 1.05 [95% CI, 1.03-1.07], P<0.001).There has been a substantial increase in ATTR-CA diagnoses, with more patients being referred after local advanced cardiac imaging. Patients are now more often diagnosed at an earlier stage of the disease, with substantially lower mortality. These changes may have important implications for initiation and outcome of therapy and urgently need to be factored into clinical trial design." @default.
- W4308059498 created "2022-11-07" @default.
- W4308059498 creator A5003019058 @default.
- W4308059498 creator A5003474421 @default.
- W4308059498 creator A5003630919 @default.
- W4308059498 creator A5004493278 @default.
- W4308059498 creator A5005309087 @default.
- W4308059498 creator A5020344924 @default.
- W4308059498 creator A5022742950 @default.
- W4308059498 creator A5023242392 @default.
- W4308059498 creator A5024753725 @default.
- W4308059498 creator A5025986417 @default.
- W4308059498 creator A5026698883 @default.
- W4308059498 creator A5033490022 @default.
- W4308059498 creator A5037509818 @default.
- W4308059498 creator A5038451700 @default.
- W4308059498 creator A5040643328 @default.
- W4308059498 creator A5046915918 @default.
- W4308059498 creator A5050125018 @default.
- W4308059498 creator A5052826173 @default.
- W4308059498 creator A5053085557 @default.
- W4308059498 creator A5057365396 @default.
- W4308059498 creator A5060284908 @default.
- W4308059498 creator A5061857871 @default.
- W4308059498 creator A5072399610 @default.
- W4308059498 creator A5073996612 @default.
- W4308059498 creator A5076688617 @default.
- W4308059498 creator A5078483151 @default.
- W4308059498 creator A5090961709 @default.
- W4308059498 date "2022-11-29" @default.
- W4308059498 modified "2023-10-18" @default.
- W4308059498 title "Impact of Earlier Diagnosis in Cardiac ATTR Amyloidosis Over the Course of 20 Years" @default.
- W4308059498 cites W1899949139 @default.
- W4308059498 cites W2033060908 @default.
- W4308059498 cites W2101817311 @default.
- W4308059498 cites W2107491044 @default.
- W4308059498 cites W2337532627 @default.
- W4308059498 cites W2735511149 @default.
- W4308059498 cites W2809989268 @default.
- W4308059498 cites W2888036721 @default.
- W4308059498 cites W2944922806 @default.
- W4308059498 cites W2948364217 @default.
- W4308059498 cites W2952648944 @default.
- W4308059498 cites W2983833521 @default.
- W4308059498 cites W2999080887 @default.
- W4308059498 cites W3016121819 @default.
- W4308059498 cites W3028686367 @default.
- W4308059498 cites W3097313145 @default.
- W4308059498 cites W3199800263 @default.
- W4308059498 cites W4229060204 @default.
- W4308059498 doi "https://doi.org/10.1161/circulationaha.122.060852" @default.
- W4308059498 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/36325894" @default.
- W4308059498 hasPublicationYear "2022" @default.
- W4308059498 type Work @default.
- W4308059498 citedByCount "23" @default.
- W4308059498 countsByYear W43080594982022 @default.
- W4308059498 countsByYear W43080594982023 @default.
- W4308059498 crossrefType "journal-article" @default.
- W4308059498 hasAuthorship W4308059498A5003019058 @default.
- W4308059498 hasAuthorship W4308059498A5003474421 @default.
- W4308059498 hasAuthorship W4308059498A5003630919 @default.
- W4308059498 hasAuthorship W4308059498A5004493278 @default.
- W4308059498 hasAuthorship W4308059498A5005309087 @default.
- W4308059498 hasAuthorship W4308059498A5020344924 @default.
- W4308059498 hasAuthorship W4308059498A5022742950 @default.
- W4308059498 hasAuthorship W4308059498A5023242392 @default.
- W4308059498 hasAuthorship W4308059498A5024753725 @default.
- W4308059498 hasAuthorship W4308059498A5025986417 @default.
- W4308059498 hasAuthorship W4308059498A5026698883 @default.
- W4308059498 hasAuthorship W4308059498A5033490022 @default.
- W4308059498 hasAuthorship W4308059498A5037509818 @default.
- W4308059498 hasAuthorship W4308059498A5038451700 @default.
- W4308059498 hasAuthorship W4308059498A5040643328 @default.
- W4308059498 hasAuthorship W4308059498A5046915918 @default.
- W4308059498 hasAuthorship W4308059498A5050125018 @default.
- W4308059498 hasAuthorship W4308059498A5052826173 @default.
- W4308059498 hasAuthorship W4308059498A5053085557 @default.
- W4308059498 hasAuthorship W4308059498A5057365396 @default.
- W4308059498 hasAuthorship W4308059498A5060284908 @default.
- W4308059498 hasAuthorship W4308059498A5061857871 @default.
- W4308059498 hasAuthorship W4308059498A5072399610 @default.
- W4308059498 hasAuthorship W4308059498A5073996612 @default.
- W4308059498 hasAuthorship W4308059498A5076688617 @default.
- W4308059498 hasAuthorship W4308059498A5078483151 @default.
- W4308059498 hasAuthorship W4308059498A5090961709 @default.
- W4308059498 hasBestOaLocation W43080594981 @default.
- W4308059498 hasConcept C126322002 @default.
- W4308059498 hasConcept C126838900 @default.
- W4308059498 hasConcept C143409427 @default.
- W4308059498 hasConcept C167135981 @default.
- W4308059498 hasConcept C2777607188 @default.
- W4308059498 hasConcept C2779902710 @default.
- W4308059498 hasConcept C2779951007 @default.
- W4308059498 hasConcept C71924100 @default.
- W4308059498 hasConcept C72563966 @default.
- W4308059498 hasConceptScore W4308059498C126322002 @default.
- W4308059498 hasConceptScore W4308059498C126838900 @default.
- W4308059498 hasConceptScore W4308059498C143409427 @default.