LAUSR

BACKGROUND Despite the improved awareness of cardiac amyloidosis among clinicians, its incidence and prevalence is not well described in a community setting. OBJECTIVE  To investigate the incidence and prevalence of cardiac amyloidosis in the community. METHODS In the adult population of Alberta, we examined 3 cohorts: 1) Probable cases of cardiac amyloidosis: the presence of physician-assigned diagnosis of amyloidosis (ICD-10 E85; ICD-9 277.3) and ≥1 healthcare encounter for heart failure (HF) (ICD-10 I50; ICD-9 428); 2) Possible cardiac amyloidosis: the presence of clinical phenotypes suggestive of amyloidosis; and 3) Comparator HF cohort without amyloidosis. RESULTS Between 2004 and 2018, 982 of the 145,329 patients with HF were identified as probable cardiac amyloidosis. During the same period, the incidence rates of probable cardiac amyloidosis increased from 1.38 to 3.69 per 100,000 person-years and the prevalence rates increased from 3.42 to 14.85 per 100,000 person-years (ptrend <0.0001). Patients with probable cardiac amyloidosis were more likely to be male, have higher comorbidity burden, greater healthcare utilization and poorer outcomes as compared to HF patients without amyloidosis. A much larger group of patients was identified as possible cardiac amyloidosis (n=46,255), with similar increase in prevalence from 2004 to 2018 (from 416 to 850 per 100,000 person-years). CONCLUSION The incidence and prevalence of cardiac amyloidosis has increased over the last decade. Given the advent of new therapies for cardiac amyloidosis and considering their high cost, it is imperative to devise strategies to screen, identify and track patients with cardiac amyloidosis from administrative databases.