(P151) A DESCRIPTIVE QUANTITATION OF CARDIAC AMYLOIDOSIS RELATED HOSPITALIZATIONS IN SASKATCHEWAN

Background: Cardiac amyloidosis (CA), a form of restrictive cardiomyopathy, is the leading cause of morbidity and mortality in patients with systemic amyloidosis. CA is understudied in Canada, with Alberta being the only provincial representation on CA incidence and prevalence. Given this lack of data, there is no evidence-based care pathway for the diagnosis and management of CA in Saskatchewan, Canada. Our study sought to characterize the CA, both light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR), population in Saskatchewan. These results will help provide the necessary evidence to guide the development of a future CA care pathway.

METHODS AND RESULTS: A single-center, retrospective chart review was conducted in in Regina and Saskatoon, Saskatchewan, Canada. All admission records between 2010 and 2020 were reviewed based on the International Classification of Disease (ICD-10) codes. A comprehensive list of patients was formulated based on discharges coded under (1) a primary or secondary ICD-10 code for systemic amyloidosis (E85) and (2) a principle or secondary ICD-10 code for HF or cardiomyopathy (I43.1). Patients were included if they had a diagnosis of systemic amyloidosis and heart failure or cardiomyopathy within 2 years after initial systemic amyloidosis diagnosis. From 467 identified patients, fifty-five patients met the inclusion criteria. The majority of these CA patients were male (65%), had hypertension (83.6%), dyslipidemia (69.0%), and heart failure (89.0%). At the time of diagnosis, CA patients often presented with non-specific symptoms. The most common electrocardiogram and echocardiogram findings were atrial fibrillation (46%), left ventricular hypertrophy (73%), and diastolic dysfunction (40%). The meant left ventricular ejection fraction was 41.72 (SD:12.42%). Over half of the included patients were on beta blockers (55%) and/or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (53%). The one-year mortality rate was 68%.

Conclusion: Patients diagnosed with CA in Saskatchewan present with non-specific symptoms, but echocardiogram and electrocardiogram findings are consistent with the literature. Given the ambiguities associated with care for patients with CA and the high one-year mortality rate, these results provide the theoretical framework and data which can translate to the development of a care pathway.