Cardiac amyloidosis and left atrial appendage closure. The CAMYLAAC study.
Rev Esp Cardiol (Engl Ed)
; 76(7): 503-510, 2023 Jul.
Article
en En, Es
| MEDLINE
| ID: mdl-35934294
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Transthyretin cardiac amyloidosis (ATTR-CA) patients often have atrial fibrillation and increased bleeding/thrombogenic risks. We aimed to evaluate outcomes of left atrial appendage closure (LAAC) compared with patients without a known diagnosis of CA.METHODS:
Comparison at long-term of patients diagnosed with ATTR-CA who underwent LAAC between 2009 and 2020 and those without a known diagnosis of CA.RESULTS:
We studied a total of 1159 patients. Forty patients (3.5%) were diagnosed with ATTR-CA; these patients were older and had more comorbidities, higher HAS-BLED and CHA2DS2-VASc scores, and lower left ventricular function. Successful LAAC was achieved in 1137 patients (98.1%) with no differences between groups. Regarding in-hospital and follow-up complications, there were no differences between the groups in ischemic stroke (5% vs 2.5% in those without a known diagnosis of CA; P=.283), hemorrhagic stroke (2.5% and 0.8% in the control group; P=.284), major or minor bleeding. At the 2-year follow-up, there were no significant differences in mortality (ATTR-CA 20% vs those without known CA 13.6%, 0.248); however, the at 5-year follow-up, ATTR-CA patients had higher mortality (40% vs 19.2%; P <.001) but this difference was unrelated to hemorrhagic complications or ischemic stroke.CONCLUSIONS:
LAAC could reduce the risk of bleeding complications and ischemic cerebrovascular events without increasing the rate of early or mid-term complications. Although long-term survival was impaired in ATTR-CA patients, it was comparable to that of patients without a known diagnosis of CA at the 2-year follow-up, suggesting that LAAC for patients with ATTR-CA might not be futile.Palabras clave
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Bases de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
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Apéndice Atrial
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Accidente Cerebrovascular
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Accidente Cerebrovascular Isquémico
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Amiloidosis
Límite:
Humans
Idioma:
En
/
Es
Revista:
Rev Esp Cardiol (Engl Ed)
Año:
2023
Tipo del documento:
Article