For a study, researchers sought to determine the relationship between the amyloidogenic Val122Ile TTR variation and the risk of heart failure and death in a large, geographically diversified cohort of Black people. Retrospective population-based cohort analysis of 7,514 self-identified Black people residing in the United States who took part in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) research and did not have heart failure at baseline. At the baseline visit, individuals were enrolled (2003-2007). The majority of outcomes reached the end of their follow-up on December 31, 2018. Data on all-cause mortality were available until December 31, 2020. The major result was an unexpected cardiac failure (first hospitalization for heart failure or death due to heart failure). Heart failure mortality, cardiovascular mortality, and all-cause death were the secondary outcomes. The Cox proportional hazards regression models were adjusted for genetic ancestry, as well as demographic, clinical, and social variables.
The population frequency of the TTR Val122Ile variation was 3.1% among 7,514 Black individuals (median age, 64 [IQR, 57-70 years]; 61% were women) (232 variant carriers and 7,282 non-carriers). During a median follow-up of 11.1 years (IQR, 5.9-13.5 years), incident heart failure occurred in 535 people (34 variant carriers and 501 non-carriers), with the incidence of heart failure being 15.64 per 1,000 person-years among variant carriers vs 7.16 per 1,000 person-years among noncarriers (adjusted hazard ratio [HR], 2.43 [95% CI, 1.71-3.46]; P<.001). Heart failure caused the deaths of 141 people (13 variant carriers and 128 non-carriers), with a rate of 6.11 per 1,000 person-years among variant carriers compared to 1.85 per 1,000 person-years among noncarriers (adjusted HR, 4.19 [95% CI, 2.33-7.54]; P<.001). The incidence of cardiovascular mortality was 15.18 per 1,000 person-years among variant carriers vs 10.61 per 1,000 person-years among noncarriers (adjusted HR, 1.69 [95% CI, 1.19-2.39]; P=.003) in a study of 793 people (34 variant carriers and 759 non-carriers). There were 2,715 deaths owing to any cause (100 variant carriers and 2,615 non-carriers), with the incidence of all-cause mortality among variant carriers 41.46 per 1,000 person-years versus 33.94 per 1,000 person-years (adjusted HR, 1.46 [95% CI, 1.19-1.78]; P<.001). On incident heart failure and secondary outcomes, there was no significant interaction between TTR variant carrier status and sex. Being a carrier of the TTR Val122Ile variation was shown to be strongly related to an elevated risk of heart failure in a group of Black Americans residing in the United States.
Reference:jamanetwork.com/journals/jama/article-abstract/2790713
