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Afro-Caribbean Heart Failure in the United Kingdom: Cause, Outcomes, and ATTR V122I Cardiac Amyloidosis.

Dungu, JN; Papadopoulou, SA; Wykes, K; Mahmood, I; Marshall, J; Valencia, O; Fontana, M; Whelan, CJ; Gillmore, JD; Hawkins, PN; et al. Dungu, JN; Papadopoulou, SA; Wykes, K; Mahmood, I; Marshall, J; Valencia, O; Fontana, M; Whelan, CJ; Gillmore, JD; Hawkins, PN; Anderson, LJ (2016) Afro-Caribbean Heart Failure in the United Kingdom: Cause, Outcomes, and ATTR V122I Cardiac Amyloidosis. Circ Heart Fail, 9 (9). e003352. ISSN 1941-3297 https://doi.org/10.1161/CIRCHEARTFAILURE.116.003352
SGUL Authors: Anderson, Lisa

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Abstract

BACKGROUND: It has been reported that subjects of African descent present with heart failure at a younger age and because of different causes than whites. We present contemporary data from UK Afro-Caribbean patients in London. METHODS AND RESULTS: All patients with heart failure presenting to St George's Hospital Heart Failure clinic between 2005 and 2012 were included (n=1392). Patients were predominantly white (71%) and male (67%), and median age at presentation was 73 years (range, 18-100 years). In 211 Afro-Caribbean patients, the most common cause of heart failure was nonischemic dilated cardiomyopathy in 27.5% (whites, 19.9%; P<0.001). Lower rates of ischemic cardiomyopathy were observed (13% versus 41%; P<0.001). The fourth most common cause of heart failure in Afro-Caribbeans was cardiac amyloidosis (11.4%). The prevalence may have been even higher as not all patients were tested for amyloidosis. Patients with ATTR V122I had the worst prognosis compared with other causes of Afro-Caribbean heart failure and white patients. To better understand this condition, we analyzed data from the largest international cohort of ATTR V122I patients, followed up at the UK National Amyloidosis Center (n=72). Patients presented with cardiac failure (median age, 75 [range, 59-90] years). Median survival was 2.6 years from diagnosis. CONCLUSIONS: In London, the cause of heart failure varies depending on ethnicity and affects age of presentation and outcomes. In Afro-Caribbean patients, ATTR V122I is an underappreciated cause of heart failure, and cardiomyopathy is often misattributed to hypertension. As promising TTR therapies are in development, increased awareness and proactive detection are needed.

Item Type: Article
Additional Information: © 2016 American Heart Association, Inc.
Keywords: amyloid, blacks, ethnology, heart failure, prognosis, amyloid, blacks, ethnology, heart failure, prognosis, amyloid, blacks, ethnology, heart failure, prognosis, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: Circ Heart Fail
ISSN: 1941-3297
Language: eng
Dates:
DateEvent
September 2016Published
12 September 2016Published Online
8 August 2016Accepted
Publisher License: Publisher's own licence
PubMed ID: 27618855
Web of Science ID: WOS:000384460800009
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108400
Publisher's version: https://doi.org/10.1161/CIRCHEARTFAILURE.116.003352

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