Frailty Is a Significant Problem for People With ATTR Cardiac Amyloidosis

Frailty remains a major problem for patients with amyloid transthyretin (ATTR) cardiac amyloidosis (ATTR-CA), according to a study being presented at the International Symposium on Amyloidosis 2024.

“From clinical experience and clinical trials, it is apparent that patients with ATTR-CA are being diagnosed earlier and with less severe disease than those seen a decade ago. Yet this remains a disease of aging. Hence, frailty is an important consideration in ATTR-CM,” the researchers noted.

In this study, the investigators assessed 116 patients with proven ATTR-CM. The subjects underwent the Short Performance Physical Battery (SPPB) and standard clinical evaluations, which consisted of a brief series of physical tests developed to analyze balance, gait speed, and unassisted standing from a chair. The SPPB is scored from 0 to 12, and a score of 8 or lower indicates frailty.

According to the results, 38.8% of patients had an SPPB score indicative of frailty. Patients with low SPPB scores had higher rates of atrial fibrillation/flutter or a paced rhythm (12/71 vs 22/45; P=.02) and higher NT-proBNP (median, 1170 [560-2459] pg/ml vs 1977 [970-3197] pg/ml; P=.024).

“In a population of patients with ATTR amyloidosis, frailty remains a substantial problem among a large minority of patients. We strongly recommend its assessment in all ATTR-CA. This can be easily achieved, in less than 10 minutes, using the easy-to-learn and simple-to-perform SPPB score,” the investigators concluded.