Assessment of potential transthyretin amyloid cardiomyopathy cases in the Brazilian public health system using a machine learning model

Isabella Zuppo Laper; Cecilia Camacho-Hubner; Rafaela Vansan Ferreira; Claudenice Leite Bertoli de Souza; Marcus Vinicius Simões; Fabio Fernandes; Edileide de Barros Correia; Ariane de Jesus Lopes de Abreu; Guilherme Silva Julian

doi:10.1371/journal.pone.0278738

Assessment of potential transthyretin amyloid cardiomyopathy cases in the Brazilian public health system using a machine learning model

PLoS One. 2024 Feb 15;19(2):e0278738. doi: 10.1371/journal.pone.0278738. eCollection 2024.

Authors

Isabella Zuppo Laper¹, Cecilia Camacho-Hubner², Rafaela Vansan Ferreira¹, Claudenice Leite Bertoli de Souza³, Marcus Vinicius Simões⁴, Fabio Fernandes⁵, Edileide de Barros Correia⁶, Ariane de Jesus Lopes de Abreu¹, Guilherme Silva Julian³

Affiliations

¹ IQVIA Brazil, São Paulo, São Paulo, Brazil.
² Pfizer Global, New York City, New York, United States of America.
³ Pfizer Brazil, São Paulo, São Paulo, Brazil.
⁴ Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
⁵ Heart Institute, University of São Paulo, São Paulo, Brazil.
⁶ Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.

Abstract

Objectives: To identify and describe the profile of potential transthyretin cardiac amyloidosis (ATTR-CM) cases in the Brazilian public health system (SUS), using a predictive machine learning (ML) model.

Methods: This was a retrospective descriptive database study that aimed to estimate the frequency of potential ATTR-CM cases in the Brazilian public health system using a supervised ML model, from January 2015 to December 2021. To build the model, a list of ICD-10 codes and procedures potentially related with ATTR-CM was created based on literature review and validated by experts.

Results: From 2015 to 2021, the ML model classified 262 hereditary ATTR-CM (hATTR-CM) and 1,581 wild-type ATTR-CM (wtATTR-CM) potential cases. Overall, the median age of hATTR-CM and wtATTR-CM patients was 66.8 and 59.9 years, respectively. The ICD-10 codes most presented as hATTR-CM and wtATTR-CM were related to heart failure and arrythmias. Regarding the therapeutic itinerary, 13% and 5% of hATTR-CM and wtATTR-CM received treatment with tafamidis meglumine, respectively, while 0% and 29% of hATTR-CM and wtATTR-CM were referred to heart transplant.

Conclusion: Our findings may be useful to support the development of health guidelines and policies to improve diagnosis, treatment, and to cover unmet medical needs of patients with ATTR-CM in Brazil.

Copyright: © 2024 Zuppo Laper et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Amyloid Neuropathies, Familial* / diagnosis
Amyloid Neuropathies, Familial* / epidemiology
Amyloidosis*
Brazil / epidemiology
Cardiomyopathies* / diagnosis
Cardiomyopathies* / epidemiology
Humans
Machine Learning
Prealbumin
Public Health
Retrospective Studies

Substances

Prealbumin

Grants and funding

This study was conducted by IQVIA Brazil and was sponsored by Pfizer Brazil. The funder provided support in the form of salaries for authors CCH, CLBS and GSJ but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.