Carpal tunnel syndrome may be early predictor of heart failure risk
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Key takeaways:
- Diagnosis of carpal tunnel syndrome was an early predictor of heart failure during 10 years of follow-up.
- The relationship was similar for men and women but differed by age.
Adults with a diagnosis of carpal tunnel syndrome are 39% more likely to develop HF during 10 years of follow-up, especially amyloidosis, compared with those without a carpal tunnel syndrome diagnosis, researchers reported.
“The increased rate of HF among patients with carpal tunnel syndrome requires attention because HF is a common disease associated with high mortality,” Mark Luedde, MD, from Christian-Albrechts-University of Kiel and Cardiology Joint Practice in Bremerhaven, Germany, and colleagues wrote in JAMA Network Open. “Early diagnosis of HF is a key to successful treatment, particularly for [transthyretin] cardiac amyloidosis, which has been associated with carpal tunnel syndrome in a recent study.”
Image: Adobe Stock
In a retrospective study, Luedde and colleagues analyzed data from 81,898 adults from 1,284 general practices in Germany with an initial diagnosis of carpal tunnel syndrome from 2005 to 2020, using the Disease Analyzer database. The mean age of patients was 53 years and 66.7% were women. Researchers used propensity-score matching to match patients without carpal tunnel syndrome to those with carpal tunnel syndrome. The main outcome was the initial diagnosis of HF up to 10 years after the index date of carpal tunnel syndrome diagnosis. As a negative control, researchers analyzed the association of carpal tunnel syndrome with cancer.
Ten years after the index date, 8.4% of patients with carpel tunnel syndrome (incidence, 8.7 cases per 1,000 patient-years) and 6.2% of patients without carpal tunnel syndrome (incidence, 6.1 cases per 1,000 patient-years) received a diagnosis of HF (P < .001).
In the regression analysis, researchers observed an association between carpal tunnel syndrome and subsequent HF diagnosis, with an HR of 1.39 (95% CI, 1.31-1.47). This association was similar for women (HR = 1.4; 95% CI, 1.3-1.5) and men (HR = 1.38; 95% CI, 1.25-1.52). However, in analyses stratified by patient age, carpal tunnel syndrome was only associated with HF among patients aged 61 to 70 years (HR = 1.48; 95% CI, 1.35-1.61) and for those older than 70 years (HR = 1.48; 95% CI, 1.35-1.61).
Across both cohorts, 47 patients in the carpal tunnel syndrome group and 17 patients in the control group received a diagnosis of amyloidosis. The adjusted HR for amyloidosis in the carpal tunnel syndrome group was 1.79 (95% CI, 1.01-3.18; P = .05).
In a sensitivity analysis using a multivariate regression model, the HR for HF was 1.24 for people with a carpal tunnel syndrome diagnosis (95% CI, 1.2-1.29) compared with those without.
Researchers did not observe any association between carpal tunnel syndrome and cancer.
The researchers wrote that the data are based on ICD-10 codes only. Also, the absolute number of patients with amyloidosis recorded was relatively small, but there is uncertainty about the proportion of patients with transthyretin cardiac amyloidosis, and underrecording is possible.
“Because our database does not offer data on the severity of CVD, we cannot ensure that both groups are balanced in this regard,” the researchers wrote. “However, our study reveals an association between carpal tunnel syndrome and HF. Thus, we point to a new role for surgeons together with general practitioners in the early detection of important internal diseases, a chance for better treatment and an improved prognosis of these diseases.”
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