A new study published in Cardiovascular Imaging found significant racial disparities in health outcomes and risk of death from transthyretin cardiac amyloidosis (ATTR-CM).
While it’s well documented that individuals of Afro-Caribbean descent experience more severe disease progression and lower survival rates in many heart conditions compared to their white peers, how this applies to ATTR-CM isn’t well understood.
To help shed light on this issue, researchers compared the outcomes of 114 Afro-Caribbean individuals and 117 white patients, all with confirmed ATTR-CM, who underwent cardiac magnetic resonance (CMR) at four academic centers between 2007 and 2023.
The results showed that compared to white patients, those of Afro-Caribbean descent had significantly more advanced disease at diagnosis, experienced worse heart failure symptoms, had higher levels of biomarkers that signal stress to the heart and had higher amounts of fluid buildup around the heart.
Learn more about ATTR-CM prognosis and staging
The differences were even more striking when it came to all-cause mortality and heart failure hospitalization. At a median follow-up of one year, 44% of patients in the study had either died or were hospitalized due to heart failure. Both outcomes were significantly more likely for the Afro-Caribbean population: these patients had a mortality rate of 46%, compared to 23% for white patients, and a higher likelihood of hospitalization from heart failure, which was 65% compared to 22%.
Despite limitations like small sample size and retrospective design, the researchers say the study highlights an urgent need for better awareness and targeted strategies to address these important health inequalities.
“In patients with ATTR-CM, Afro-Caribbean race is associated with more advanced disease stage at the time of diagnosis, reduced treatment with life prolonging therapies, and worse outcomes in ATTR-CM,” they concluded. “Further studies are needed to understand the specific drivers of poor outcomes in [Afro-Caribbean] patients with ATTR-CM with the aim of ultimately developing targeted strategies aimed to address healthcare disparities in this patient population.”
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