Carpal Tunnel Syndrome in Patients Who Underwent Pacemaker Implantation and Relation to Amyloidosis, Heart Failure, and Mortality
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Advances in treatment warrant earlier diagnosis of cardiac amyloidosis (CA). Common cardiac and extracardiac manifestations of CA, such as pacemaker implantation and carpal tunnel syndrome (CTS), might provide screening opportunities for CA. However the association between CTS and CA in patients undergoing pacemaker implantation has not been well studied. This study examined the association between previous CTS surgery and adverse cardiovascular outcomes in patients who underwent pacemaker implantation. Using Danish nationwide registries, we identified all patients ≥50 years who underwent first-time pacemaker implantation during 2000 to 2018, examining the association between previous CTS surgery and adverse cardiovascular outcomes 5 years after pacemaker implantation. Cumulative incidence functions and Cox proportional hazard models were used to assess the differences. Among 57,315 patients who underwent pacemaker implantation, 2.2% (n = 1,266) had previous CTS surgery. Patients in the CTS cohort were older, more often female, and had more co-morbidities than patients without CTS. The cumulative 5-year mortality was higher among patients with CTS (44.6% [41.1% to 47.9%] versus 40.2% [39.7% to 40.6%], p = 0.04). In the adjusted models, previous CTS surgery was not associated with increased 5-year mortality, but it was associated with an increased rate of hospitalization for new-onset heart failure, (hazard ratio 1.32 [1.11 to 1.57], p = 0.002) and a higher risk of amyloidosis diagnosis after pacemaker implantation (hazard ratio 7.72 [2.96 to 20.10], p <0.0001), compared with no previous CTS surgery. In patients who underwent pacemaker implantation, adjusted models showed that previous CTS surgery was associated with a higher incidence of hospitalization for new-onset heart failure and amyloidosis diagnosis after pacemaker implantation. Screening for CA may be considered in patients undergoing pacemaker implantation.
| Original language | English |
|---|---|
| Journal | American Journal of Cardiology |
| Volume | 177 |
| Pages (from-to) | 121-127 |
| ISSN | 0002-9149 |
| DOIs | |
| Publication status | Published - 2022 |
Bibliographical note
Funding Information:
Dr. Westin reports financial support provided by Erik and Susanna Olesen’s Charitable Foundation. Dr. Westin reports independent research grants from Pfizer, Arvid Nilssons Fond, Højmosegård-legatet, Frimodt-Heineke Fonden and Hjertecentrets forskningsudvalg, Rigshospitalet, outside the submitted work. Dr. Butt reports advisory board honoraria from Bayer, outside the submitted work. Dr. Gustafsson reports personal fees from Abbott, AstraZeneca, Pfizer, Boehringer-Ingelheim, Novartis and Orion Pharma, and other from Corvia, outside the submitted work. Dr. Køber reports speakers honorarum from Novartis, AstraZeneca, Novo and Boehringer, outside the submitted work. Dr. Maurer reports grant support from NIH R01HL139671, R21AG058348 and K24AG036778. Dr. Maurer has had consulting income from Pfizer, Eidos, Prothena, Akcea and Alnylam, and his institution recieved clinical trial funding from Pfizer, Prothena, Eidos and Alnylam. Dr. Fosbøl reports independent research grant from Novo Nordisk Foundation, outside the submitted work. Dr. Vinther has no conflict of interest to declare.
Funding Information:
Statistics Denmark provided the data underlying this article, with permission from the Danish Data Protection Agency. If permitted by the Danish Data Protection Agency, data will be shared upon request to the corresponding author. Dr. Westin reports financial support was provided by Erik and Susanna Olesen's Charitable Foundation. Dr. Westin reports grants from Pfizer, Arvid Nilssons Fond, Højmosegård-legatet, Frimodt-Heineke Fonden, and Hjertecentrets forskningsudvalg, Rigshospitalet outside of the submitted work. Dr. Butta reports advisory board honoraria from Bayer, outside the submitted work. Dr. Gustafsson reports personal fees from Abbott, AstraZeneca, Pfizer, Boehringer-Ingelheim, Novartis, and Orion Pharma, and other from Corvia, outside the submitted work. Dr. Køber reports speakers honorarium from Novartis, AstraZeneca, Novo, and Boehringer outside of the submitted work. Dr. Maurer has had consulting income from Pfizer, Eidos, Prothena, Akcea, and Alnylam, and his institution received clinical trial funding from Pfizer, Prothena, Eidos, and Alnylam. Dr. Fosbøl reports independent research grant from Novo Nordisk Foundation outside of the submitted work. Dr. Vinther has no conflict of interest to declare. Dr. Westin reports financial support provided by Erik and Susanna Olesen's Charitable Foundation. Dr. Westin reports independent research grants from Pfizer, Arvid Nilssons Fond, Højmosegård-legatet, Frimodt-Heineke Fonden and Hjertecentrets forskningsudvalg, Rigshospitalet, outside the submitted work. Dr. Butt reports advisory board honoraria from Bayer, outside the submitted work. Dr. Gustafsson reports personal fees from Abbott, AstraZeneca, Pfizer, Boehringer-Ingelheim, Novartis and Orion Pharma, and other from Corvia, outside the submitted work. Dr. Køber reports speakers honorarum from Novartis, AstraZeneca, Novo and Boehringer, outside the submitted work. Dr. Maurer reports grant support from NIH R01HL139671, R21AG058348 and K24AG036778. Dr. Maurer has had consulting income from Pfizer, Eidos, Prothena, Akcea and Alnylam, and his institution recieved clinical trial funding from Pfizer, Prothena, Eidos and Alnylam. Dr. Fosbøl reports independent research grant from Novo Nordisk Foundation, outside the submitted work. Dr. Vinther has no conflict of interest to declare.
Funding Information:
Dr. Westin reports financial support was provided by Erik and Susanna Olesen's Charitable Foundation. Dr. Westin reports grants from Pfizer, Arvid Nilssons Fond, Højmosegård-legatet, Frimodt-Heineke Fonden, and Hjertecentrets forskningsudvalg, Rigshospitalet outside of the submitted work. Dr. Butta reports advisory board honoraria from Bayer, outside the submitted work. Dr. Gustafsson reports personal fees from Abbott, AstraZeneca, Pfizer, Boehringer-Ingelheim, Novartis, and Orion Pharma, and other from Corvia, outside the submitted work. Dr. Køber reports speakers honorarium from Novartis, AstraZeneca, Novo, and Boehringer outside of the submitted work. Dr. Maurer has had consulting income from Pfizer, Eidos, Prothena, Akcea, and Alnylam, and his institution received clinical trial funding from Pfizer, Prothena, Eidos, and Alnylam. Dr. Fosbøl reports independent research grant from Novo Nordisk Foundation outside of the submitted work. Dr. Vinther has no conflict of interest to declare.
ID: 325829110