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The prevalence of anxiety and depression is high in patients with ATTR-CA, particularly among older females, emphasizing the need for increased awareness and evaluation of psychological burden in this population.

There is a comparatively increased prevalence of anxiety and depression among adults with different cardiovascular diseases (CVD) relative to the general population. However, to date, there have been no studies analyzing the prevalence of anxiety and depression in individuals with transthyretin cardiac amyloidosis (ATTR-CA), which is a CVD characterized by the deposition of TTR-derived amyloid in the extracellular space. A study published in the journal Frontiers in Psychology found a high prevalence of depression and anxiety in ATTR-CA patients. Offering psychological support to these patients can help counter the disease burden and enhance their quality of life. 

Psychological Burden of Transthyretin Cardiac Amyloidosis

ATTR-CA is associated with pain, discomfort, depression, anxiety, and tiredness. This study evaluated the psychological burden in ATTR-CA patients, since the pathology is linked to impairment in quality of life and physical health and reduced productivity.

Overall Prevalence of Anxiety and Depression in ATTR-CA Patients

Anxiety and depression were found to be prevalent in patients with ATTR-CA compared to the control group, with 48.6% (n=53) of the patients reporting anxious or depressive symptoms in the clinical range. The prevalence of these symptoms was not greater in the hereditary ATTR  (ATTR-v) subgroup patients compared to ATTR-wild type (ATTR-wt) patients.

Age- and Sex-Based Prevalence of Depression and Anxiety

Older ATTR-CA patients, particularly female patients with an advanced disease course, exhibited a greater prevalence of depression and anxiety symptoms. Older and especially female patients are at a greater risk for developing an anxiety disorder.

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Female Transthyretin Cardiac Amyloidosis Patients in the Study Population

The low number of female ATTR-CA patients in the study population may influence the generalizability of the study results. Gender constituted a significant predictor for anxiety symptoms, whereas New York Heart Association class and gender were the predictors for depression symptoms.

Association of Clinical and Sociodemographic Risk Factors

There was no significant association between the clinical and sociodemographic risk factors with depression and anxiety symptoms in the clinical range.

This study concluded that there is a dire need for increased awareness and coherent evaluation of anxiety and depression symptoms in ATTR-CA patients.


Smorti, M., Ponti, L., Soffio, F., Argirò, A., Perfetto, F., Zampieri, M., Mazzoni, C., Tomberli, A., Allinovi, M., Di Mario, C., Olivotto, I., & Cappelli, F. (2022). Prevalence of anxiety and depression symptoms in a sample of outpatients with ATTR cardiac amyloidosis. Front Psychol, 13, 1066224. https://doi.org/10.3389/fpsyg.2022.1066224