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Carpal tunnel syndrome increases rate of amyloidosis by 12-fold
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Patients with carpal tunnel syndrome who underwent surgical treatment had an increased risk for HF and amyloidosis compared with controls, according to a study published in the Journal of the American College of Cardiology.
“Together with prior studies, this study suggests that [carpal tunnel syndrome] in some cases may be an early marker for adverse cardiovascular outcomes that are consistent with the development of [wild-type transthyretin amyloidosis],” Emil L. Fosbøl, MD, PhD, of The Heart Center at the University Hospital of Copenhagen Rigshospitalet in Denmark, and colleagues wrote.
Researchers analyzed data from 56,032 patients (mean age, 54 years; 68% women) who underwent surgical treatment for carpal tunnel syndrome between 1996 and 2012. A sex- and age-matched cohort from the general population was also included in the study.
The outcomes of interest were HF hospitalization and an inpatient or outpatient diagnosis of amyloidosis. Secondary outcomes of interest were atrioventricular block, atrial fibrillation and pacemaker and/or intracardiac defibrillator implantation. Patients were followed up until death, an outcome, emigration or the end of the study, whichever came first.
Patients with carpal tunnel syndrome had an increased risk for a future diagnosis of amyloidosis (adjusted HR = 12.12; 95% CI, 4.37-33.6). These patients also had a higher incidence of HF after adjustment (aHR = 1.54; 95% CI, 1.45-1.64).
Researchers found no significant interaction with sex (P = .5).
Patients with carpal tunnel syndrome also had an increased risk for adverse outcomes including atrioventricular block (HR = 1.28; 95% CI, 0.91-1.81), AF (HR = 1.45; 95% CI, 1.3-1.61) and HF (HR = 1.51; 95% CI, 1.33-1.71).
“[Carpal tunnel syndrome] may not merit direct referral for further evaluation for amyloidosis but could rather be considered a red flag and an opportunity for early disease detection,” Fosbøl and colleagues wrote.
“Carpal tunnel syndrome in select patients may serve as an early warning sign may years prior to the onset of amyloidosis, giving clinicians ample opportunities to screen and monitor for amyloid development; however, many questions remain,” Van-Khue Ton, MD, PhD, assistant professor of medicine in the division of cardiology at the University of Maryland School of Medicine in Baltimore, and colleagues wrote in a related editorial. – by Darlene Dobkowski
Disclosures: Fosbøl and Ton report no relevant financial disclosures. Please see the study and editorial for all other authors’ relevant financial disclosures.
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