Conference Coverage

Study Examines Fall- and Fracture-Related Hospitalizations in ATTR-CM

Edited by:
Brian McCurdy

Key Highlights

  • Each matched cohort included 6,663 patients in each cohort: ATTR-CM, non-ATTR heart failure, or non-heart failure.
  • Fracture-related hospitalizations were significantly higher in ATTR-CM than in both comparator cohorts.
  • Fall-related hospitalizations were significantly higher than in non-HF controls, but the difference versus HF controls was not statistically significant.
  • The researchers found that median costs per patient and per patient per year were significantly higher in ATTR-CM.

Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) experienced significantly more fracture-related hospitalizations and higher related costs than matched heart failure (HF) and non-HF control patients in a retrospective claims analysis presented at the Heart Failure Society of America Annual Scientific Meeting. Fall-related hospitalizations were also more frequent than in non-HF controls, although the comparison with HF controls did not reach statistical significance.

The investigators examined the burden of falls and fractures in ATTR-CM, which they described as a multisystem disease associated with functional decline. Their objective was to compare related hospitalizations and costs with those in patients with non-ATTR HF and patients without either diagnosis.

Researchers used Optum’s de-identified Clinformatics Data Mart database covering January 2016 through July 2025. Adults aged ≥18 years were assigned to cohorts using ICD-10-CM claims from January 2018 through July 2024. The ATTR-CM and HF cohorts required more than 1 corresponding diagnosis claim, while non-HF controls had neither diagnosis and at least 1 disease-related claim. Exclusions included light chain amyloidosis, multiple myeloma, chemotherapy, transplant, and ventricular assist devices.

Cohorts were propensity score-matched 1:1:1 by age, sex, race, ethnicity, and geography, with at least 12 months of follow-up. Investigators evaluated hospitalizations using Poisson models with robust standard errors and compared median costs using Mann-Whitney U tests.

Study Findings

Each cohort included 6,663 patients. Mean follow-up was 3.0 years for ATTR-CM, 2.9 years for HF, and 3.3 years for non-HF controls. Fall-related hospitalizations numbered 973, 904, and 281, respectively. The ATTR-CM comparison was not statistically significant versus HF (P = .091) but was significant versus non-HF controls (P < .001).

Fracture-related hospitalizations numbered 541 in ATTR-CM, compared with 519 in HF (P = .003) and 199 in non-HF controls (P < .001). Patients with ATTR-CM incurred significantly higher median costs per patient and per patient per year than both comparator cohorts.

Clinical Implications

According to the authors, the findings are consistent with substantial ATTR-CM disease burden beyond cardiac manifestations and increased healthcare resource utilization.

Expert Commentary

“ATTR-CM was associated with increased fall- and fracture-related hospitalizations and related costs compared with matched HF and non-HF controls,” the researchers concluded.

Reference

Hasan S, Bart NK, Allison M, et al. Falls and fractures drive increased hospitalizations and costs in patients with transthyretin amyloid cardiomyopathy compared with controls. HFSA ePoster Library. October 9, 2026. Abstract 90. ePoster 4235397.