Abstract Body (Do not enter title and authors here):
Background:
Cardiac amyloidosis is an underdiagnosed cause of heart failure. The mean survival rate without treatment is low, signifying the importance of early diagnosis. The prognosis depends on the time of diagnosis and the severity of the disease before recognition and treatment. We performed a systematic review to evaluate patient characteristics and mortality in individuals with cardiac amyloidosis.

Methods:
PubMed, Scopus and Cochrane were systematically searched from the database inception to May 2024 to evaluate for mortality outcomes in patients with cardiac amyloidosis. The statistical analysis was performed using R-Studio software, and proportions with 95% confidence intervals (CI) were calculated using a random-effects model. The Kaplan Meier survival plots was also plotted for eligible studies.

Results:
Eighteen studies involving 7,268 patients were included. Patients with cardiac amyloidosis mostly presented with dyspnea and peripheral edema. Among the electrocardiographic abnormalities, atrial fibrillation was observed in 31.1% of patients, whereas atrioventricular block was observed in 6.2% of patients. Furthermore, 37.2% of patients experienced heart failure, 36.3% experienced reduced ejection fraction, and 3.2% of patients experienced cardiogenic shock. Majority of the patients were found to have an increase in left ventricular wall thickness (77.8%). The mortality associated with cardiac amyloidosis varied from 0% to 100%, with a summary estimate rate of 54% (95% CI: 31% to 77%). The median survival rate for 50% patients was around 2 weeks, which declined significantly over the next one week resulting into the cumulative survival of over only 21 days.

Conclusion:
Our results highlight the importance of considering cardiac amyloidosis in the differential diagnosis of all patients with heart failure or non-ischemic cardiomyopathy, particularly when there is an increase in ventricular wall thickness. Our review revealed a high mortality rate associated with cardiac amyloidosis. Early diagnosis and better therapeutic modalities have the potential to improve patient outcomes and reduce mortality rates.