Analysis: Amyloidosis Diagnoses Vary Regionally, Undercount Blacks

Results from a new cohort study suggested an underdiagnosis of amyloidosis among black U.S. residents, as well a high degree of regional variability of amyloidosis diagnoses.  

Researchers for the paper, published online in JAMA Cardiology, looked at death certificate information from the CDC’s Wide-ranging Online Data for Epidemiologic Research database and the National Vital Statistics System between 1979 and 2015. The analysis included a total of 30,764 U.S. individuals with amyloidosis listed as the cause of death, and 26,591 in whim amyloidosis was listed as a contributing cause of death. Outcomes of interest included age-adjusted amyloidosis mortality rate per million (population stratified by year, sex, race, and state/county of residence).  

US mortality data revealed significant underdetection of #amyloidosis, particularly in #AfricanAmericans. Learn more https://t.co/57o2kxFoBP

— JAMA Cardiology (@JAMACardio) July 30, 2018

According to their results, the over adjusted morality rate from amyloidosis as a primary cause of death doubled from 1.77 to 3.96 per million. Black men were the group with the highest mortality rate (12.36 per million), followed by black women (6.48 per million). Some counties had age-adjusted mortality rates as high as 31.73 per million. Souther states reported the lowest mortality rates, even though they had the highest proportions of black individuals. 

“The lack of higher reported mortality rates in the states with a greater proportion of black residents suggests underdiagnosis of amyloidosis, including cardiac forms of the disease, in many areas of the United States,” the researchers wrote. “Better understanding of the determinants of geographic and racial disparity in the reporting of amyloidosis deaths are warranted.”  

DocWire News has written previously on the topic of disparities in cardiac care for blacks and other groups.  

Another study showing ethnic differences in mortality, for the same disease…
Geographic Disparities in Reported US Amyloidosis Mortality During 1979 to 2015 https://t.co/u2leik9Sc4

— Dr Jason Dungu PhD FRCP FESC (@drjasondungu) July 31, 2018

Important data @JAMACardio. Don’t overlook this unique risk in #AfricanAmericans. New amyloidosis therapies provide some optimism. https://t.co/Jg4bbprFP1

— Clyde Yancy, MD, MSc (@NMHheartdoc) July 30, 2018

Observational cohort study finds overall mean age-adjusted mortality rate from #amyloidosis as the underlying cause of death has doubled from 1.77 to 3.96 per 1,000,000 population, probably due to increase in disease diagnosis: https://t.co/MTeefj5Dd6. pic.twitter.com/N7aZZQmph5

— Robert Z. Orlowski (@Myeloma_Doc) July 28, 2018

Source: JAMA Cardiology