TY - JOUR

T1 - Association of Carpal Tunnel Syndrome With Amyloidosis, Heart Failure, and Adverse Cardiovascular Outcomes

AU - Fosbøl, Emil L.

AU - Rørth, Rasmus

AU - Leicht, Birgitte Pernille

AU - Schou, Morten

AU - Maurer, Mathew S.

AU - Kristensen, Søren Lund

AU - Kober, Lars

AU - Gustafsson, Finn

PY - 2019/7

Y1 - 2019/7

N2 - Background: Recent studies have suggested that transthyretin amyloidosis (ATTR) is a more common cause of heart failure (HF) than previously appreciated, and novel treatments for amyloidosis are emerging. About one-half of patients with ATTR cardiac amyloidosis have a history of carpal tunnel syndrome (CTS). Objectives: This study examined the risk of amyloidosis, HF, and other adverse cardiovascular outcomes associated with CTS relative to control subjects without CTS. Methods: Using Danish nationwide registries from 1996 to 2012, 56,032 patients were identified who underwent surgical treatment for CTS, and they were compared with a sex- and age-matched cohort (ratio 1:1) from the general population to examine their risk of amyloidosis, HF, and other adverse cardiovascular outcomes. Cumulative incidence curves and Cox proportional hazard models were used to assess differences. Results: As expected, CTS was associated with a future diagnosis of amyloidosis (hazard ratio: 12.12 [95% confidence interval: 4.37 to 33.60]). CTS was associated with a higher incidence of HF, and this held true in the adjusted analysis yielding a hazard ratio of 1.54 (95% confidence interval: 1.45 to 1.64). No significant interaction with sex was found (p = 0.5). Risk of other adverse outcomes was also associated with CTS (p < 0.0001 for atrial fibrillation, atrioventricular heart block, and pacemaker implantation). Conclusions: Patients who undergo surgical treatment for CTS are associated with a higher risk of amyloidosis and HF relative to matched control subjects from the general population. Other cardiovascular outcomes were also increased with CTS.

AB - Background: Recent studies have suggested that transthyretin amyloidosis (ATTR) is a more common cause of heart failure (HF) than previously appreciated, and novel treatments for amyloidosis are emerging. About one-half of patients with ATTR cardiac amyloidosis have a history of carpal tunnel syndrome (CTS). Objectives: This study examined the risk of amyloidosis, HF, and other adverse cardiovascular outcomes associated with CTS relative to control subjects without CTS. Methods: Using Danish nationwide registries from 1996 to 2012, 56,032 patients were identified who underwent surgical treatment for CTS, and they were compared with a sex- and age-matched cohort (ratio 1:1) from the general population to examine their risk of amyloidosis, HF, and other adverse cardiovascular outcomes. Cumulative incidence curves and Cox proportional hazard models were used to assess differences. Results: As expected, CTS was associated with a future diagnosis of amyloidosis (hazard ratio: 12.12 [95% confidence interval: 4.37 to 33.60]). CTS was associated with a higher incidence of HF, and this held true in the adjusted analysis yielding a hazard ratio of 1.54 (95% confidence interval: 1.45 to 1.64). No significant interaction with sex was found (p = 0.5). Risk of other adverse outcomes was also associated with CTS (p < 0.0001 for atrial fibrillation, atrioventricular heart block, and pacemaker implantation). Conclusions: Patients who undergo surgical treatment for CTS are associated with a higher risk of amyloidosis and HF relative to matched control subjects from the general population. Other cardiovascular outcomes were also increased with CTS.

KW - amyloidosis

KW - carpal tunnel syndrome

KW - heart failure

UR - http://www.scopus.com/inward/record.url?scp=85067802615&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2019.04.054

DO - 10.1016/j.jacc.2019.04.054

M3 - Journal article

C2 - 31272537

AN - SCOPUS:85067802615

VL - 74

SP - 15

EP - 23

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 1

ER -