Incidence and determinants of atrial fibrillation in patients with wild-type transthyretin cardiac amyloidosis.
Int J Cardiol
; 392: 131346, 2023 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-37689398
ABSTRACT
BACKGROUND:
Data on the incidence and factors associated with de novo atrial fibrillation (AF) in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) is limited. We described the incidence and factors associated with de novo AF in patients diagnosed with ATTRwt-CA to drive tailored arrhythmia screening.METHODS:
Multicenter, retrospective, observational cohort study performed in six referral centers for CA. All consecutive patients diagnosed with ATTRwt-CA between 2004 and 2020 with >6-month follow up (FU) were enrolled and divided into three groups according to presence of AF (1)patients with 'known AF'; (2)patients in 'sinus rhythm' and (3)patients developing 'de novo AF' during FU. Incidence and factors associated with AF in patients with ATTRwt were the primary outcomes.RESULTS:
Overall, 266 patients were followed for a median of 19 [11-33] months 148 (56%) with known AF, 84 (31.6%) with sinus rhythm, and 34 (12.8%) with de novo AF. At Fine-Gray competing risk analysis to account for mortality, PR (sub-distribution hazard ratio [SHR] per Δms 1.008, 95% C.I. 1.001-1.013, p = 0.008), QRS (SHR per Δms 1.012, 95% C.I. 1.001-1.022, p = 0.046) and left atrial diameter ≥ 50 mm (SHR 2.815,95% C.I. 1.483-5.342, p = 0.002) were associated with de novo AF. Patients with at least two risk factors (PR ≥ 200 ms, QRS ≥ 120 ms or LAD≥50 mm) had a higher risk of developing de novo AF compared to patients with no risk factors (HR 14.918 95% C.I. 3.242-31.646, p = 0.008).CONCLUSIONS:
At the end of the study almost 70% patients had AF. Longer PR and QRS duration and left atrial dilation are associated with arrhythmia onset.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Itália