Healthcare Resource Utilization of Patients with ATTR-CM Compared with Matched Cohort of Patients with HF

The clinical understanding of transthyretin-mediated cardiac amyloidosis (ATTR-CM) continues to expand as registry data are emerging in published research, but treatment patterns and healthcare resource utilization for patients with ATTR-CM are not well-documented. In contrast to the breadth of data available in heart failure (HF), existing studies of healthcare resource utilization in ATTR-CM have been limited to small populations without inclusion of a relevant comparator population. This European-based study is the first of its kind and aimed to describe the healthcare resource utilization of patients with ATTR-CM in Denmark, Finland, Norway, and Sweden compared with a matched cohort of patients with HF.

This retrospective observational cohort study used nationwide healthcare registries and identified patients from 2008 through 2018. From the time of identification, patients were followed until death or the end of the study period. Patients in the ATTR-CM cohort were matched 1:1 to patients with HF (without concurrent ATTR-CM) based on birth year, sex, and year of diagnosis. Patients in the ATTR-CM cohort who could not be matched were excluded from the analysis. Healthcare resource–utilization analysis of a matched pair was halted once one of the patients was lost to follow-up to avoid distortion of results.

Of the 1833 patients with ATTR-CM identified, 1831 were able to be matched to patients with HF and were included in the analysis. Women represented 31% of the ATTR-CM patient population, with the mean age ranging from 71.5 to 75.5 years across countries. In all years of the analysis, healthcare resource utilization was higher among patients with ATTR-CM versus those with HF. During the year following diagnosis, 76.6% of patients with ATTR-CM had ≥3 outpatient visits per year compared with 65.6% of those with HF, and 45.5% of patients with ATTR-CM were hospitalized ≥3 times per year compared with 39.2% of those with HF. The mean number of outpatient visits in the year following diagnosis among patients with ATTR-CM was 10.2 compared with a mean of 5.7 visits in patients with HF. During the year following diagnosis, statistically significant differences were seen among patients with ATTR-CM compared with those with HF in mean number of hospitalizations (3.3 vs 2.5), hospitalization days (21.7 vs 15.2), and surgical procedures (1.7 vs 1.06), respectively.

Lower healthcare resource utilization among patients with HF may reflect the availability of effective treatment options for HF in the years 2008 to 2018; however, it may also illustrate the difficulties in appropriately treating ATTR-CM and the importance of earlier diagnosis. These results suggest that the health of patients with ATTR-CM deteriorates more quickly than it may in patients with HF, increasing healthcare needs; therefore, patients with ATTR-CM generally have a higher burden on healthcare systems compared with matched patients with HF. Strategies leading to earlier diagnosis of ATTR-CM should be explored further as they may lessen some of the healthcare resource utilization of patients with ATTR-CM.

Source

Lauppe R, Liseth Hansen J, Fornwall A, et al. Healthcare resource use of patients with transthyretin amyloid cardiomyopathy. ESC Heart Fail. 2022;9(3):1636-1642.

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