Association of Carpal Tunnel Syndrome With Amyloidosis, Heart~Failure, and Adverse Cardiovascular Outcomes

Tags: etiology, carpal tunnel, pro, overuse injury, injury, pain problems, hand & wrist, arm, limbs

One article on PainSci cites Fosbøl 2019: Complete Guide to Frozen Shoulder

PainSci notes on Fosbøl 2019:

This study is focused on an increased risk of heart failure in carpal tunnel syndrome patients, but, as a musculoskeletal medicine guy, I am more interested in the reverse implication: that CTS is probably partially or entirely triggered by some underlying biology that makes things harder for hearts.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Recent studies have suggested that transthyretin amyloidosis (ATTR) is a more common cause of heart failure (HF) than previously appreciated, and novel treatments for amyloidosis are emerging. About one-half of patients with ATTR cardiac amyloidosis have a history of carpal tunnel syndrome (CTS).

OBJECTIVES: This study examined the risk of amyloidosis, HF, and other adverse cardiovascular outcomes associated with CTS relative to control subjects without CTS.

METHODS: Using Danish nationwide registries from 1996 to 2012, 56,032 patients were identified who underwent surgical treatment for CTS, and they were compared with a sex- and age-matched cohort (ratio 1:1) from the general population to examine their risk of amyloidosis, HF, and other adverse cardiovascular outcomes. Cumulative incidence curves and Cox proportional hazard models were used to assess differences.

RESULTS: As expected, CTS was associated with a future diagnosis of amyloidosis (hazard ratio: 12.12 [95\% confidence interval: 4.37 to 33.60]). CTS was associated with a higher incidence of HF, and this held true in the adjusted analysis yielding a hazard ratio of 1.54 (95\% confidence interval: 1.45 to 1.64). No significant interaction with sex was found (p~=~0.5). Risk of other adverse outcomes was also associated with CTS (p~\<~0.0001 for atrial fibrillation, atrioventricular heart block, and pacemaker implantation).

CONCLUSIONS: Patients who undergo surgical treatment for CTS are associated with a higher risk of amyloidosis and HF relative to matched control subjects from the general population. Other cardiovascular outcomes were also increased with CTS.

This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights: