Cardiac amyloidosis and left atrial appendage closure. The CAMYLAAC Study

Autor: Ignacio J. Amat-Santos, José R. Delgado-Arana, Ignacio Cruz-González, Hipólito Gutiérrez, Ignacio García-Bolao, Xavier Millán, Gabriela Tirado-Conte, Juan Miguel Ruiz-Nodar, Mohsen Mohandes, Jorge Palazuelos, Francisco Torres Saura, Raquel Del Valle, Ernesto Valero Picher, Jean Carlos Núñez García, Itziar Gómez, Ramón Albarrán Rincón, Dabit Arzamendi, Luis Nombela-Franco, Liza Korniiko, Alejandro Barrero, Sandra Santos-Martínez, Ana Serrador, J. Alberto San Román
Rok vydání: 2022
Předmět:
Zdroj: Revista Espanola De Cardiologia (english Ed.)
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname
REVISTA ESPANOLA DE CARDIOLOGIA
r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
r-FISABIO. Repositorio Institucional de Producción Científica
ISSN: 1885-5857
Popis: 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 ofCA.; 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. Copyright © 2022 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
Databáze: OpenAIRE
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