{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:29:25Z","timestamp":1793946565751,"version":"4.8.0"},"reference-count":39,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000038","name":"U.S. Food and Drug Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Advances"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jacadv.2026.102627","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T19:16:10Z","timestamp":1774466170000},"page":"102627","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Differences in Hospitalizations in the 6 Months Before a Diagnosis of Transthyretin Amyloid Cardiomyopathy"],"prefix":"10.1016","volume":"5","author":[{"given":"Chun Shing","family":"Kwok","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan I.","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Steeds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":false,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6362-0253","authenticated-orcid":false,"given":"Biykem","family":"Bozkurt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5074-2078","authenticated-orcid":false,"given":"Marianna","family":"Fontana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian D.","family":"Gillmore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Moody","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacadv.2026.102627_bib1","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1002\/ehf2.12518","article-title":"Transthyretic cardiac amyloidosis: an update on diagnosis and treatment","volume":"6","author":"Yamamoto","year":"2019","journal-title":"ESC Heart Fail"},{"key":"10.1016\/j.jacadv.2026.102627_bib2","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.pcad.2024.01.013","article-title":"Advances in the diagnosis and treatment of transthyretic amyloid cardiomyopathy","volume":"82","author":"Vasishnav","year":"2024","journal-title":"Prog Cardiovasc Dis"},{"key":"10.1016\/j.jacadv.2026.102627_bib3","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1177\/2047487319884371","article-title":"Red flags in cardiac amyloidosis","volume":"27","author":"Kwok","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"10.1016\/j.jacadv.2026.102627_bib4","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1161\/CIRCULATIONAHA.122.060852","article-title":"Impact of earlier diagnosis in cardiac ATTR amyloidosis over the course of 20 years","volume":"146","author":"Ioannou","year":"2022","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.102627_bib5","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.ijcard.2019.12.063","article-title":"Diagnostic delay in wild type transthyretin cardiac amyloidosis \u2013 a clinical challenge","volume":"304","author":"Ladefoged","year":"2020","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacadv.2026.102627_bib6","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1080\/13506129.2018.1498782","article-title":"Seven factors predict delayed diagnosis of cardiac amyloidosis","volume":"25","author":"Bishop","year":"2018","journal-title":"Amyloid"},{"issue":"Suppl 1","key":"10.1016\/j.jacadv.2026.102627_bib7","article-title":"Delays in diagnosis and treatment initiation of ATTR cardiac amyloidosis: a real-world data analysis","volume":"45","author":"Vogel","year":"2024","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacadv.2026.102627_bib8","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1002\/ejhf.2646","article-title":"Sex differences among patients with transthyretin amyloid cardiomyopathy \u2013 from diagnosis to prognosis","volume":"24","author":"Patel","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacadv.2026.102627_bib9","doi-asserted-by":"crossref","DOI":"10.1177\/17539447231216318","article-title":"The importance of pathways to facilitate early diagnosis and treatment of patients with cardiac amyloidosis","volume":"17","author":"Kwok","year":"2023","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"10.1016\/j.jacadv.2026.102627_bib10","first-page":"233","article-title":"Coron artery","volume":"33","author":"Kwok","year":"2022","journal-title":"Dis"},{"key":"10.1016\/j.jacadv.2026.102627_bib11","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.3390\/healthcare10091798","article-title":"Should audits consider the care pathway model? A new approach to benchmarking real-world activities","volume":"10","author":"Kwok","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"10.1016\/j.jacadv.2026.102627_bib12","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s11897-022-00551-4","article-title":"Missed opportunities in the diagnosis of heart failure: evaluation of pathways to determine sources of delay to specialist evaluation","volume":"19","author":"Kwok","year":"2022","journal-title":"Curr Heart Fail Rep"},{"key":"10.1016\/j.jacadv.2026.102627_bib13","doi-asserted-by":"crossref","first-page":"455","DOI":"10.3390\/jcdd9120455","article-title":"A critical evaluation of patient pathways and missed opportunities in the treatment of heart failure","volume":"9","author":"Kwok","year":"2022","journal-title":"J Cardiovasc Dev Dis"},{"key":"10.1016\/j.jacadv.2026.102627_bib14","article-title":"Hospitalizations during the 30-day period preceding admissions with ST-elevation myocardial infarction: insights from the Nationwide Readmission Database","volume":"427","author":"Kwok","year":"2025","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacadv.2026.102627_bib16","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1056\/NEJMoa1805689","article-title":"Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy","volume":"379","author":"Maurer","year":"2018","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacadv.2026.102627_bib18","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s10741-023-10339-w","article-title":"Sex differences in transthyretin cardiac amyloidosis","volume":"29","author":"Aimo","year":"2024","journal-title":"Heart Fail Rev"},{"key":"10.1016\/j.jacadv.2026.102627_bib19","doi-asserted-by":"crossref","DOI":"10.1161\/circ.148.suppl_1.18202","article-title":"Sex differences in transthyretin amyloid cardiomyopathy","volume":"148","author":"Jefferson","year":"2023","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.102627_bib20","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.jchf.2021.05.005","article-title":"Sex-related risk of cardiac involvement in hereditary transthyretin amyloidosis: insights from THAOS","volume":"9","author":"Caponetti","year":"2021","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.jacadv.2026.102627_bib21","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1056\/NEJMoa2305434","article-title":"Efficacy and safety of acoramidis in transthyretin amyloid cardiomyopathy","volume":"390","author":"Gillmore","year":"2024","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacadv.2026.102627_bib22","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1161\/CIRCULATIONAHA.122.062532","article-title":"The future for patients with transthyretin cardiac amyloidosis is brighter","volume":"146","author":"Patel","year":"2022","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.102627_bib23","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1161\/CIRCULATIONAHA.118.038169","article-title":"Natural history, quality of life, and outcome in cardiac transthyretin amyloidosis","volume":"140","author":"Lane","year":"2019","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.102627_bib24","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s40119-021-00219-5","article-title":"Impact of delayed diagnosis and misdiagnosis for patients with transthyretic amyloid cardiomyopathy (ATTR-CM): a targeted literature review","volume":"10","author":"Rozenbaum","year":"2021","journal-title":"Cardiol Ther"},{"key":"10.1016\/j.jacadv.2026.102627_bib25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s44156-023-00028-7","article-title":"British Society of Echocardiography guidelines for the transthoracic echocardiographic assessment of cardiac amyloidosis","volume":"10","author":"Moody","year":"2023","journal-title":"Echo Res Pract"},{"key":"10.1016\/j.jacadv.2026.102627_bib26","article-title":"Cardiac amyloidosis: epidemiology, diagnosis and therapy","volume":"19","author":"Papingiotis","year":"2021","journal-title":"E-J Cardiol Pract"},{"key":"10.1016\/j.jacadv.2026.102627_bib27","series-title":"StatPearls","article-title":"Hypertensive Heart Disease","author":"Shams","year":"2025"},{"key":"10.1016\/j.jacadv.2026.102627_bib28","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1038\/ajh.2008.16","article-title":"Left ventricular hypertrophy and clinical outcomes in hypertensive patients","volume":"21","author":"Ruilope","year":"2008","journal-title":"Am J Hypertens"},{"key":"10.1016\/j.jacadv.2026.102627_bib29","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.pcad.2019.11.009","article-title":"Left ventricular hypertrophy and hypertension","volume":"63","author":"Yildiz","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"10.1016\/j.jacadv.2026.102627_bib30","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41581-019-0244-2","article-title":"The global epidemiology of hypertension","volume":"16","author":"Mills","year":"2020","journal-title":"Nat Rev Nephrol"},{"key":"10.1016\/j.jacadv.2026.102627_bib31","first-page":"18","article-title":"Cardiac amyloidosis: the great masquerade","volume":"2018","author":"Rind","year":"2018","journal-title":"Glob Cardiol Sci Pract"},{"key":"10.1016\/j.jacadv.2026.102627_bib32","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1186\/s12875-020-01252-4","article-title":"Avoiding misdiagnosis: expert consensus recommendations for the suspicion and diagnosis of transthyretin amyloidosis for the general practitioner","volume":"23","author":"Gertz","year":"2020","journal-title":"BMC Fam Pract"},{"key":"10.1016\/j.jacadv.2026.102627_bib33","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.124.012075","article-title":"Socioeconomic disparities are associated with delayed access to tafamadis in transthyretin cardiac amyloidosis","volume":"17","author":"Miller","year":"2024","journal-title":"Circ Heart Fail"},{"issue":"6","key":"10.1016\/j.jacadv.2026.102627_bib34","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.jaccao.2024.05.001","article-title":"Race and socioeconomic status impact diagnosis and clinical outcomes in transthyretin cardiac amyloidosis","volume":"18","author":"Shankar","year":"2024","journal-title":"JACC CardioOncol"},{"key":"10.1016\/j.jacadv.2026.102627_bib35","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.cardfail.2024.10.037","article-title":"Socioeconomic deprivation and the severity of newly diagnosed transthyretin cardiac amyloidosis: is there a link?","volume":"31","author":"Fahed","year":"2025","journal-title":"J Cardiac Fail"},{"key":"10.1016\/j.jacadv.2026.102627_bib36","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jchf.2018.10.007","article-title":"Heart failure and liver disease: cardiohepatic interactions","volume":"7","author":"Xanthopoulos","year":"2019","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.jacadv.2026.102627_bib37","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1136\/heartasia-2011-010023","article-title":"Liver diseases in heart failure","volume":"3","author":"Maleki","year":"2011","journal-title":"Heart Asia"},{"key":"10.1016\/j.jacadv.2026.102627_bib38","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/ejhf.440","article-title":"Liver function tests in patients with acute heart failure and associated outcomes: insights from ASCEND-HF","volume":"18","author":"Samsky","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jacadv.2026.102627_bib39","doi-asserted-by":"crossref","first-page":"2804","DOI":"10.1093\/eurheartj\/eht246","article-title":"Interactions of the heart and the liver","volume":"34","author":"Moller","year":"2013","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacadv.2026.102627_bib40","doi-asserted-by":"crossref","first-page":"80","DOI":"10.3350\/kjhep.2011.17.1.80","article-title":"Hepatic amyloidosis","volume":"17","author":"Shin","year":"2011","journal-title":"Korean J Hepatol"},{"key":"10.1016\/j.jacadv.2026.102627_bib41","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.033094","article-title":"Multiorgan dysfunction and associated prognosis in transthyretin cardiac amyloidosis","volume":"13","author":"Ioannou","year":"2024","journal-title":"J Am Heart Assoc"}],"container-title":["JACC: Advances"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772963X2600044X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772963X2600044X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T05:50:47Z","timestamp":1793944247000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772963X2600044X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S2772963X2600044X"],"URL":"https:\/\/doi.org\/10.1016\/j.jacadv.2026.102627","relation":{},"ISSN":["2772-963X"],"issn-type":[{"value":"2772-963X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sex Differences in Hospitalizations in the 6 Months Before a Diagnosis of Transthyretin Amyloid Cardiomyopathy","name":"articletitle","label":"Article Title"},{"value":"JACC: Advances","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacadv.2026.102627","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.","name":"copyright","label":"Copyright"}],"article-number":"102627"}}