For a study, researchers sought to see if the amyloidogenic Val122Ile (TTR) transthyretin variation was linked to the risk of heart failure and death in a large, geographically varied cohort of Black people. Retrospective population-based cohort analysis of 7,514 self-identified Black people living in the United States were participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study who did not have heart failure at baseline. At the baseline visit, the individuals were enrolled (2003-2007). The bulk of outcomes was followed up until December 31, 2018. Data on all-cause mortality was available until December 31, 2020. The population frequency of the TTR Val122Ile variation was 3.1% (232 variant carriers and 7,282 non-carriers). Among 7,514 Black individuals (median age, 64 years [IQR, 57-70 years]; 61% women). The incidence of heart failure was 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) during a median follow-up of 11.1 years (IQR, 5.9-13.5 years). 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). Cardiovascular death occurred in 793 people (34 variant carriers and 759 non-carriers), with a rate of 15.18 per 1,000 person-years among variant carriers compared to 10.61 per 1,000 person-years among noncarriers (adjusted HR, 1.69 [95% CI, 1.19-2.39]; P=.003). All-cause mortality was 41.46 per 1,000 person-years among variant carriers vs 33.94 per 1,000 person-years among noncarriers (adjusted HR: 1.46 [95% CI: 1.19-1.78]; P<.001). There was no significant interaction between TTR variant carrier status and sex on incident heart failure and secondary outcomes. Being a carrier of the TTR Val122Ile variation was linked to an elevated risk of heart failure in a group of Black Americans residing in the United States.
Source:jamanetwork.com/journals/jama/article-abstract/2790713
