DOI: 10.1161/jaha.125.047135 ISSN: 2047-9980

Temporal Trends in Incidence and Prevalence of Transthyretin Amyloid Cardiomyopathy in the United States

Kevin M. Alexander, Noel R. Dasgupta, Jimmi Mathisen, Sidsel Gamborg Møller, Anders Tvistholm, Mathew S. Maurer
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Background

Advances in diagnosis and disease awareness have led to increased prevalence and incidence of transthyretin amyloid cardiomyopathy (ATTR‐CM), but current US population‐based epidemiologic data are lacking. This study aimed to estimate temporal trends and current prevalence and incidence of ATTR‐CM in the United States and to describe patient characteristics and the clinical burden.

Methods

Data from the US Merative MarketScan Medicare Database (2010–2021) and the IQVIA PharMetrics Plus (2016–2023) claims database were assessed. An algorithm using codes for diagnoses and clinical drugs was used to identify patients with ATTR‐CM among individuals ≥18 years old. Incidence, prevalence, demographics, comorbidities, medication use, and clinical encounters were assessed annually in cross‐sectional cohorts.

Results

The incidence and prevalence of ATTR‐CM became higher over time, particularly in men and older age groups. The incidence per 100 000 person‐years was 44.3 (95% CI, 39.4–49.2) in 2021 for the Medicare Database (individuals aged ≥65 years) and 5.4 (95% CI, 5.0–5.8) in 2022 for PharMetrics Plus (individuals aged ≥18 years); the prevalence per 100 000 individuals was 95.8 (95% CI, 89.2–102.4) in 2022 in the Medicare Database and 11.3 (95% CI, 10.8–11.8) in 2023 in PharMetrics Plus. The number of comorbidities and medication use in the year before diagnosis increased over time; the number of clinical encounters in the year before diagnosis was relatively stable.

Conclusions

The incidence and prevalence of ATTR‐CM diagnoses have increased in the United States from 2010 to 2023, and the clinical burden among newly diagnosed individuals has become more complex.

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