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Original Article
- Temporal trends in the prevalence, incidence, and mortality of cardiac amyloidosis in Korea over 12 years
- You-Jung Choi, Yun Jin Choi, Jieun Lee, Jah Yeon Choi, Geum Joon Cho, Jin Oh Na
- Epidemiol Health. 2024;46:e2024078. Published online September 15, 2024
- DOI: https://doi.org/10.4178/epih.e2024078
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AbstractOBJECTIVES
This study investigated the prevalence, incidence, and prognosis of cardiac amyloidosis (CA) in Korea.METHODSThis retrospective nationwide population-based study used the Health Insurance Review and Assessment Service databases between 2008 and 2020. All patients diagnosed with amyloidosis were included, and those with a diagnosis of heart failure or cardiomyopathy were classified as having CA. Both the special code for amyloidosis (V121), which enables coverage of medical expenses, and the corresponding International Classification of Diseases, 10th revision codes for amyloidosis (E850- E854, E858, E859) were used to improve the reliability of amyloidosis diagnosis.RESULTSAmong 2,239 patients with amyloidosis, 758 met the criteria for CA (mean age, 64.4±11.9 years; 59.1% male). The mean age of patients with CA increased from 59.5±14.7 years in 2009 to 68.1±13.9 years in 2020. The incidence and prevalence increased from 0.09 (95% confidence interval [CI], 0.06 to 0.12) to 0.22 (95% CI, 0.18 to 0.27) per 100,000 person-years and 0.20 (95% CI, 0.16 to 0.25) to 1.30 (95% CI, 0.12 to 0.42) per 100,000 persons, respectively (all p<0.001). Patients with light-chain CA showed similar trends. In-hospital mortality decreased from 17.3% (95% CI, 9.23 to 29.6) to 6.10% (95% CI, 4.21 to 8.48) between 2009 and 2020. While age-specific in-hospital mortality was significantly higher in patients aged ≥70 years (p=0.004), no significant age-specific difference in in-hospital mortality was observed in patients with CA aged <70 years (p=0.981).CONCLUSIONSThe prevalence and incidence of CA have increased in Korea, predominantly affecting older individuals, particularly males. Notably, in-hospital mortality decreased significantly. -
SummaryKorean summary
본 연구는 2009년부터 2020년까지 한국에서의 심장 아밀로이드증의 역학을 조사했으며, 유병률과 발생률이 시간이 지남에 따라 유의미하게 증가하고, 환자의 평균 연령도 높아지는 추세를 보였습니다. 특히, 전체 환자에서 입원 중 사망률이 크게 감소하며 치료와 관리가 개선되었음을 보여주었으나, 70세 이하에서는 심장 아밀로이드증으로 인한 사망이 나이에 따른 차이를 보이지 않아 조기 발견 및 적극적인 치료의 중요성이 강조되었습니다.Key Message
This study investigated the epidemiology of cardiac amyloidosis in South Korea from 2009 to 2020, revealing a significant increase in prevalence and incidence over time, along with a rise in the median age of patients. Notably, in-hospital mortality decreased substantially across all patients, reflecting improvements in treatment and management. However, among patients under 70 years of age, mortality due to cardiac amyloidosis showed no significant age-related differences, underscoring the importance of early detection and proactive treatment.
Brief Communication
- Association between cardiac arrhythmia before pregnancy and gestational diabetes: a nationwide population-based study in Korea
- You-Jung Choi, Won Young Wi, Geum Joon Cho, Jin Oh Na
- Epidemiol Health. 2023;45:e2023103. Published online December 4, 2023
- DOI: https://doi.org/10.4178/epih.e2023103
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- 168 Download
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Supplementary Material -
AbstractGiven the higher prevalence of cardiac arrhythmias in individuals with diabetes, we investigated the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM). This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. After excluding those who did not undergo National Health Screening tests within 1 year prior to pregnancy, those with multifetal pregnancies, and those diagnosed with diabetes, we analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy, and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension. Therefore, cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
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SummaryKorean summary
본 연구에서는 부정맥과 임신성 당뇨병의 발생과의 관계를 확인인하기 위하여 2007년부터 2015년까지 국민건강보험 공단 데이터를 이용하여 분만력을 가진 1,113,729명의 여성을 대상으로 진행되었습니다. 최종 분석은 과거 당뇨병 진단병력을 가지고 있는 환자를 제외하고 365,880건의 단태아 임산부를 포함하였고, 전체 대상자 중 31,938 (8.7%)에서 임신성 당뇨병을 확인하였습니다. 그 중 부정맥 병력이 확인되지 않은 임산부와 비교하였을 때, 부정맥 병력이 있는 경우 임신 기간 중 임신성 당뇨병 발생률이 높았으며 (8.7% vs. 14.9%, p<0.001), 다변량 분석에서도 부정맥과 임신 당뇨병 간의 연관성이 통계적으로 유의미하게 나타났습니다 (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). 따라서, 본 연구는 임신 전후의 부정맥 병력은 임신성 당뇨병 발병 위험 증가와 관련 있음을 시사합니다.Key Message
This nationwide population-based cross-sectional study using the Korean Health Insurance Service database showed that women with a history of cardiac arrhythmia had an elevated risk of incident GDM during pregnancy. The prevalence of GDM was significantly higher in women with cardiac arrhythmias (8.7% vs. 14.9%). There was a statistically significant association between cardiac arrhythmia and GDM (adjusted odds ratio: 1.78), suggesting that cardiac arrhythmias before and during pregnancy are linked to an increased risk of developing GDM, independent of age, BMI, and chronic hypertension.
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