Prevalence of frailty in cardiac transthyretin amyloidosis: A systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Cardiac amyloidosis (CA) is an increasingly recognized cause of heart failure. Frailty is common among older adults and strongly associated with adverse outcomes. However, its prevalence and clinical relevance in the context of CA have not been systematically examined. This review aimed to assess the prevalence of frailty in CA and qualitatively synthesize the evidence on its association with clinical outcomes. METHODS: A systematic review and meta-analysis of observational studies was conducted to assess frailty prevalence in CA. Databases searched included Embase, PubMed, CINAHL, Cochrane Library, and Google Scholar up to April 15, 2025. Studies reporting frailty prevalence in CA patients were included. Six assessors independently screened the articles, extracted data, and resolved conflicts by consensus. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Out of 565 articles identified, six studies met inclusion criteria, including a total of 1422 participants with cardiac transthyretin amyloidosis (ATTR-CA). Reported frailty prevalence ranged from 14.5 % to 75 %, depending on the assessment method. A meta-analysis restricted to studies using the Clinical Frailty Scale (N = 1164) yielded a pooled frailty prevalence of 66 % (95 % CI, 57-74 %), with substantial heterogeneity (I² = 89.1 %). Frailty was consistently associated with higher mortality and poorer quality of life. CONCLUSIONS: Frailty is highly prevalent in individuals with ATTR-CA and is independently associated with adverse clinical outcomes. These findings support the routine evaluation of frailty in the management of individuals with CA. PROSPERO registration (CRD42024607807).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.041 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.040 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".