Prevalence of frailty in cardiac transthyretin amyloidosis: A systematic review and meta-analysis

IF 12.4 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-10-05 DOI:10.1016/j.arr.2025.102903

Alberto Finazzi , Emma Esposito , Chiara Riva , Elisabetta Mangili , Lorenzo Lodovici , Adriana Antonella Bruni , Elena Pinardi , Maria Cristina Ferrara , Daniela Pini , Antonella Zambon , Francesco Musca , Stefano Perlini , Chukwuma Okoye , Giuseppe Bellelli

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引用次数: 0

Abstract

Background

Cardiac amyloidosis (CA) is an increasingly recognized cause of heart failure. Frailty is common among older adults and strongly associated with adverse outcomes. However, its prevalence and clinical relevance in the context of CA have not been systematically examined. This review aimed to assess the prevalence of frailty in CA and qualitatively synthesize the evidence on its association with clinical outcomes.

Methods

A systematic review and meta-analysis of observational studies was conducted to assess frailty prevalence in CA. Databases searched included Embase, PubMed, CINAHL, Cochrane Library, and Google Scholar up to April 15, 2025. Studies reporting frailty prevalence in CA patients were included. Six assessors independently screened the articles, extracted data, and resolved conflicts by consensus. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale.

Results

Out of 565 articles identified, six studies met inclusion criteria, including a total of 1422 participants with cardiac transthyretin amyloidosis (ATTR-CA). Reported frailty prevalence ranged from 14.5 % to 75 %, depending on the assessment method. A meta-analysis restricted to studies using the Clinical Frailty Scale (N = 1164) yielded a pooled frailty prevalence of 66 % (95 % CI, 57–74 %), with substantial heterogeneity (I² = 89.1 %). Frailty was consistently associated with higher mortality and poorer quality of life.

Conclusions

Frailty is highly prevalent in individuals with ATTR-CA and is independently associated with adverse clinical outcomes. These findings support the routine evaluation of frailty in the management of individuals with CA. PROSPERO registration (CRD42024607807).

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心脏转甲状腺蛋白淀粉样变的脆弱患病率：一项系统回顾和荟萃分析

背景：心脏淀粉样变性（CA）越来越被认为是导致心力衰竭的原因。虚弱在老年人中很常见，并与不良后果密切相关。然而，在CA的背景下，其患病率和临床相关性尚未被系统地检查。本综述旨在评估CA中虚弱的患病率，并定性地综合其与临床结果相关的证据。方法对观察性研究进行系统回顾和荟萃分析，以评估CA的虚弱患病率。检索的数据库包括Embase、PubMed、CINAHL、Cochrane Library和谷歌Scholar，截止日期为2025年4月15日。纳入了报告CA患者虚弱患病率的研究。六名评估员独立筛选文章，提取数据，并通过共识解决冲突。纳入研究的方法学质量采用纽卡斯尔-渥太华量表进行评估。结果在565篇文章中，6项研究符合纳入标准，包括1422名心脏转甲状腺蛋白淀粉样变（atr - ca）患者。根据评估方法的不同，报告的虚弱患病率从14.5 %到75 %不等。一项荟萃分析局限于使用临床虚弱量表（N = 1164）的研究，得出虚弱患病率为66 %(95 % CI, 57-74 %)，具有显著的异质性（I²= 89.1 %）。虚弱始终与较高的死亡率和较差的生活质量有关。结论：虚弱在atr - ca患者中非常普遍，并且与不良临床结果独立相关。这些发现支持对CA. PROSPERO注册患者（CRD42024607807）进行常规虚弱评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.