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dc.contributor.authorVilches, Silvia
dc.contributor.authorFontana, Marianna
dc.contributor.authorGonzalez-Lopez, Esther
dc.contributor.authorMitrani, Lindsey
dc.contributor.authorSaturi, Giulia
dc.contributor.authorRenju, Mary
dc.contributor.authorGriffin, Jan M.
dc.contributor.authorCaponetti, Angelo
dc.contributor.authorGnanasampanthan, Sahana
dc.contributor.authorDe los Santos3, Jeffeny
dc.contributor.authorGagliardi, Christian
dc.contributor.authorRivas, Adrian
dc.contributor.authorDominguez, Fernando
dc.contributor.authorLonghi, Simone
dc.contributor.authorRapezzi, Claudio
dc.contributor.authorMaurer, Mathew S.
dc.contributor.authorGillmore, Julian
dc.contributor.authorGarcía Pavía, Pablo
dc.description.abstractAims 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 CHA2DS2-VASc score in this setting. Methods and results 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. CHA2DS2-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). Conclusions 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 CHA2DS2-VASc score did not correlate well with clinical outcome in ATTR-CM and should not be used to assess thromboembolic risk in this
dc.publisherEuropean Journal of Heart Failurespa
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 España*
dc.subjectCardiac amyloidosisspa
dc.subjectAtrial fibrillationspa
dc.titleSystemic embolism in amyloid transthyretin
dc.description.extent615 KBspa

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Atribución-NoComercial-SinDerivadas 3.0 España
Except where otherwise noted, this item's license is described as Atribución-NoComercial-SinDerivadas 3.0 España