Background: The prevalence and clinical impact of frailty in transthyretin cardiac amyloidosis (ATTR-CA) remains poorly characterized. Objectives: This study aimed to evaluate the prevalence, clinical determinants, and prognostic significance of frailty in a large cohort of patients with ATTR-CA. Methods: Frailty was assessed in 880 patients with ATTR-CA (median age 80 years [Q1-Q3: 75-84 years], 719 [81.7%] male) using the Clinical Frailty Scale (CFS). Frailty was analyzed as a continuous variable and categorized as CFS 1 to 3, CFS 4 or 5, CFS 6 or 7, and CFS 8 or 9. Results: Frailty was observed in 502 (57.1%) patients (CFS 4 or 5: 364 [41.4%]; CFS 6 or 7: 129 [14.7%]; CFS 8 or 9: 9 [1.0%]). Independent predictors of worsening frailty included older age, female sex, non-p.(V142I) hereditary ATTR-CA variants, and National Amyloidosis Centre stage 3 disease. Mortality rates increased incrementally with frailty severity (deaths per 100 person-years: 2.9 vs 11.0 vs 21.1 vs 40.9; log-rank P < 0.001). F
Clinical Phenotype and Prognostic Significance of Frailty in Transthyretin Cardiac Amyloidosis / Fumagalli C., Ioannou A., Cappelli F., Maurer M.S., Razvi Y., Porcari A., Zampieri M., Perfetto F., Rauf M.U., Martinez-Naharro A., Venneri L., Petrie A., Whelan C., Wechalekar A., Lachmann H., Hawkins P.N., Olivotto I., Marfella R., Ungar A., Marchionni N., et al.. - In: JACC. CARDIOONCOLOGY. - ISSN 2666-0873. - ELETTRONICO. - 7:(2025), pp. 268-278. [10.1016/j.jaccao.2025.01.018]
Clinical Phenotype and Prognostic Significance of Frailty in Transthyretin Cardiac Amyloidosis
Fumagalli C.;Cappelli F.;Zampieri M.;Perfetto F.;Olivotto I.;Ungar A.;Marchionni N.;
2025
Abstract
Background: The prevalence and clinical impact of frailty in transthyretin cardiac amyloidosis (ATTR-CA) remains poorly characterized. Objectives: This study aimed to evaluate the prevalence, clinical determinants, and prognostic significance of frailty in a large cohort of patients with ATTR-CA. Methods: Frailty was assessed in 880 patients with ATTR-CA (median age 80 years [Q1-Q3: 75-84 years], 719 [81.7%] male) using the Clinical Frailty Scale (CFS). Frailty was analyzed as a continuous variable and categorized as CFS 1 to 3, CFS 4 or 5, CFS 6 or 7, and CFS 8 or 9. Results: Frailty was observed in 502 (57.1%) patients (CFS 4 or 5: 364 [41.4%]; CFS 6 or 7: 129 [14.7%]; CFS 8 or 9: 9 [1.0%]). Independent predictors of worsening frailty included older age, female sex, non-p.(V142I) hereditary ATTR-CA variants, and National Amyloidosis Centre stage 3 disease. Mortality rates increased incrementally with frailty severity (deaths per 100 person-years: 2.9 vs 11.0 vs 21.1 vs 40.9; log-rank P < 0.001). F
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