Racial and Ethnic Disparities in Transthyretin Cardiac Amyloidosis

Purpose of Review Transthyretin amyloid cardiomyopathy (ATTR-CM) is a life-threatening disease that disproportionately affects older adults and people of African descent. This review discusses current knowledge regarding racial and ethnic disparities in the diagnosis and management of ATTR-CM. Recen...

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Bibliographic Details
Published in:Current cardiovascular risk reports 2021-06, Vol.15 (6), p.8, Article 8
Main Authors: Spencer-Bonilla, Gabriela, Njoroge, Joyce N., Pearson, Keon, Witteles, Ronald M., Aras, Mandar A., Alexander, Kevin M.
Format: Article
Language:English
Subjects:
Amyloidosis
Cardiac arrhythmia
Cardiology
Cardiomyopathy
Clinical outcomes
Heart failure
Immunoglobulins
Medical prognosis
Medicine
Medicine & Public Health
Mortality
Mutation
Race and Ethnicity Disparities (M. Albert and L. Brewer
Section Editors
Stem cells
Topical Collection on Race + Ethnicity Disparities
Transplants & implants
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Summary:Purpose of Review Transthyretin amyloid cardiomyopathy (ATTR-CM) is a life-threatening disease that disproportionately affects older adults and people of African descent. This review discusses current knowledge regarding racial and ethnic disparities in the diagnosis and management of ATTR-CM. Recent Findings Historically, ATTR-CM was thought to be a rare cause of heart failure. Recent evidence has shown that ATTR-CM is more common among older adults, men, and people of African descent. In addition, significant geographic variation exists in the identification of amyloid cardiomyopathy. Despite the high burden of ATTR-CM among Black individuals, most clinical data for ATTR-CM are from North America and Europe. Moreover, only a minority of clinical trial participants thus far have been Black patients. In addition to racial differences, socioeconomic disparities may be further compounded by the potentially prohibitive cost and limited accessibility of disease-modifying ATTR therapies. Summary ATTR-CM is an important cause of heart failure that disproportionately affects people of African descent. Efforts to promote earlier identification of ATTR-CM in general practice will likely improve clinical outcomes for all groups. Future trials should strive to enroll a higher proportion of Black patients. Furthermore, enhanced efforts are warranted to improve treatment accessibility among racial and ethnic minority groups that may be more likely to be affected by ATTR-CM.
ISSN:1932-9520
1932-9563
DOI:10.1007/s12170-021-00670-y