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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure With and Without Amyloidosis: A Nationwide Propensity-Matched Analysis

by
Aravind Dilli Babu
1,*,
Mirza Faris Ali Baig
2,
David A. Baran
3,
Jerry Estep
4,
David Wolinsky
4,
Nina Thakkar Rivera
3,
Ram Bhutani
1,
Harshit Narula
1,
Prashant Chaulagain
1 and
David Snipelisky
1
1
Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA
2
Department of Internal Medicine, Asante Three Rivers Medical Center, Grants Pass, OR 97527, USA
3
Advanced Heart Failure and Transplantation Section of Heart Failure & Cardiac Transplant Medicine, Cleveland Clinic, Weston, FL 33331, USA
4
Department of Cardiology, Cleveland Clinic, Weston, FL 33331, USA
*
Author to whom correspondence should be addressed.
J. Cardiovasc. Dev. Dis. 2025, 12(5), 190; https://doi.org/10.3390/jcdd12050190 (registering DOI)
Submission received: 8 February 2025 / Revised: 4 April 2025 / Accepted: 22 April 2025 / Published: 16 May 2025
(This article belongs to the Topic Cardiovascular Disease in Special Populations: From Basic Science to Clinical Practice)
Versions Notes

Abstract

Cardiac amyloidosis (CA), an infiltrative restrictive cardiomyopathy, is a frequently underrecognized etiology of diastolic heart failure (HF). This study aimed to evaluate inpatient outcomes among patients hospitalized with decompensated diastolic HF with and without a secondary diagnosis of amyloidosis, utilizing data from the National Inpatient Sample (2018–2021). Among 2,444,699 patients hospitalized for decompensated diastolic HF, 9205 (0.3%) had a documented secondary diagnosis of amyloidosis. After 1:1 propensity-score matching, 1841 patients in each group were analyzed. Multivariate logistic regression revealed that the presence of amyloidosis was associated with significantly higher odds of in-hospital mortality (4.0% vs. 2.7%), cardiogenic shock (5.4% vs. 2.4%), acute kidney injury (28.3% vs. 22.0%), ventricular tachycardia (12.4% vs. 6.0%), and acute myocardial injury (9.5% vs. 6.0%) (all p < 0.05). Additionally, patients with amyloidosis had a longer mean length of stay (7.1 vs. 5.7 days) and higher mean hospitalization costs ($85,594 vs. $48,484, p < 0.05). Although the overall incidence of acute myocardial injury was elevated, subgroup analysis of ST-elevation and non–ST-elevation myocardial infarction revealed no significant differences. These findings underscore the considerable clinical and economic burden of amyloidosis in patients hospitalized with decompensated diastolic heart failure.
Keywords: amyloidosis; cardiovascular disease; heart failure; propensity score match amyloidosis; cardiovascular disease; heart failure; propensity score match

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MDPI and ACS Style

Dilli Babu, A.; Ali Baig, M.F.; Baran, D.A.; Estep, J.; Wolinsky, D.; Rivera, N.T.; Bhutani, R.; Narula, H.; Chaulagain, P.; Snipelisky, D. Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure With and Without Amyloidosis: A Nationwide Propensity-Matched Analysis. J. Cardiovasc. Dev. Dis. 2025, 12, 190. https://doi.org/10.3390/jcdd12050190

AMA Style

Dilli Babu A, Ali Baig MF, Baran DA, Estep J, Wolinsky D, Rivera NT, Bhutani R, Narula H, Chaulagain P, Snipelisky D. Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure With and Without Amyloidosis: A Nationwide Propensity-Matched Analysis. Journal of Cardiovascular Development and Disease. 2025; 12(5):190. https://doi.org/10.3390/jcdd12050190

Chicago/Turabian Style

Dilli Babu, Aravind, Mirza Faris Ali Baig, David A. Baran, Jerry Estep, David Wolinsky, Nina Thakkar Rivera, Ram Bhutani, Harshit Narula, Prashant Chaulagain, and David Snipelisky. 2025. "Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure With and Without Amyloidosis: A Nationwide Propensity-Matched Analysis" Journal of Cardiovascular Development and Disease 12, no. 5: 190. https://doi.org/10.3390/jcdd12050190

APA Style

Dilli Babu, A., Ali Baig, M. F., Baran, D. A., Estep, J., Wolinsky, D., Rivera, N. T., Bhutani, R., Narula, H., Chaulagain, P., & Snipelisky, D. (2025). Comparative Insights on Inpatient Outcomes in Diastolic Heart Failure With and Without Amyloidosis: A Nationwide Propensity-Matched Analysis. Journal of Cardiovascular Development and Disease, 12(5), 190. https://doi.org/10.3390/jcdd12050190

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