2026-05-22T01:42:43Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/156472024-09-27T08:43:18Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Vilches, Silvia author Fontana, Marianna author Gonzalez-Lopez, Esther author Mitrani, Lindsey author Saturi, Giulia author Renju, Mary author Griffin, Jan M author Caponetti, Angelo author Gnanasampanthan, Sahana author De Los Santos, Jeffeny author Gagliardi, Christian author Rivas, Adrian author Dominguez, Fernando author Longhi, Simone author Rapezzi, Claudio author Maurer, Mathew S author Gillmore, Julian author Garcia-Pavia, Pablo author 2022-08 Although systemic embolism is a potential complication in transthyretin amyloid cardiomyopathy (ATTR-CM), data about its incidence and prevalence are scarce. We studied the incidence, prevalence and factors associated with embolic events in ATTR-CM. Additionally, we evaluated embolic events according to the type of oral anticoagulation (OAC) and the performance of the CHA2 DS2 -VASc score in this setting. Clinical characteristics, history of atrial fibrillation (AF) and embolic events were retrospectively collected from ATTR-CM patients evaluated at four international amyloid centres. Overall, 1191 ATTR-CM patients (87% men, median age 77.1 years [interquartile range-IQR 71.4-82], 83% ATTRwt) were studied. A total of 162 (13.6%) have had an embolic event before initial evaluation. Over a median follow-up of 19.9 months (IQR 9.9-35.5), 41 additional patients (3.44%) had an embolic event. Incidence rate (per 100 patient-years) was 0 among patients in sinus rhythm with OAC, 1.3 in sinus rhythm without OAC, 1.7 in AF with OAC, and 4.8 in AF without OAC. CHA2 DS2 -VASc did not predict embolic events in patients in sinus rhythm whereas in patients with AF without OAC, only those with a score ≥4 had embolic events. There was no difference in the incidence rate of embolism between patients with AF treated with vitamin K antagonists (VKAs) (n = 322) and those treated with direct oral anticoagulants (DOACs) (n = 239) (p = 0.66). Embolic events were a frequent complication in ATTR-CM. OAC reduced the risk of systemic embolism. Embolic rates did not differ with VKAs and DOACs. The CHA2 DS2 -VASc score did not correlate well with clinical outcome in ATTR-CM and should not be used to assess thromboembolic risk in this population. Eur J Heart Fail. 2022 Aug;24(8):1387-1396 10.1002/ejhf.2566 1879-0844 European journal of heart failure 35650018 http://hdl.handle.net/20.500.12105/15647 Systemic embolism in amyloid transthyretin cardiomyopathy.