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Original article Temporal trends in the prevalence, incidence, and mortality of cardiac amyloidosis in South Korea over 12 years
You-Jung Choi1,2orcid , Yun Jin Choi3orcid , Ji Eun Lee1orcid , Jah Yeon Choi1orcid , Geum Joon Cho3,4orcid , Jin Oh Na1orcid
Epidemiol Health 2024;e2024078
DOI: https://doi.org/10.4178/epih.e2024078 [Accepted]
Published online: September 15, 2024
1Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
2Biomedical Research Institute Seoul National University Hospital, Seoul, Korea
3Biomedical Research Institute, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
4Department of Obstetrics and Gynecology, Korea University Guro Hospital, Seoul, Korea
Corresponding author:  Jin Oh Na,
Email: koolup93@gmail.com
Received: 2 June 2024   • Revised: 16 August 2024   • Accepted: 19 August 2024
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Abstract

Objectives
This study investigated the prevalence, incidence, and prognosis of cardiac amyloidosis (CA) in South Korea.
Methods
This 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.
Results
Among 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], 0.06–0.12) to 0.22 (95% CI, 0.18–0.27) per 100,000 person-years and 0.20 (95% CI, 0.16–0.25) to 1.30 (95% CI, 0.12–0.42) 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%–29.6%) to 6.1% (95% CI, 4.21%–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).
Conclusions
The prevalence and incidence of CA have increased in South Korea, predominantly affecting older individuals, particularly males. Notably, in-hospital mortality decreased significantly.

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