AI Article Synopsis
- Atrial fibrillation (AF) is prevalent in patients with transthyretin cardiac amyloidosis (ATTR-CA), and there's no clear best way to prevent strokes in these patients.
- A study compared outcomes for patients with ATTR-CA and AF who were treated with warfarin versus those treated with novel oral anticoagulants (NOACs), analyzing data from 290 patients.
- Results showed that while patients with AF had a higher risk of thrombotic events, there was no significant difference in stroke, major bleeding, or death between those taking warfarin and those on NOACs during a follow-up period.
Article Abstract
Background: Atrial fibrillation (AF) is common in patients with transthyretin cardiac amyloidosis (ATTR-CA). The optimal strategy to prevent strokes in patients with ATTR-CA and AF is unknown.
Objectives: To compare outcomes in patients with ATTR-CA and AF treated with warfarin versus novel oral anticoagulants (NOACs).
Methods: This study was a retrospective analysis of patients with ATTR-CA stratified by presence or absence of AF and anticoagulation therapy. The primary outcome included a time to event analysis for the combined outcomes of stroke, transient ischaemic attack (TIA), major bleed, or death.
Results: Of 290 patients, 217 patients (74.8%) had AF. Of those with AF ( = 217), 78 (35.9%) patients received warfarin compared with 116 (53.5%) patients who received NOACs. There were 17 thrombotic events, all in those diagnosed with AF compared with none in the patients without AF ( = .01). Over a mean follow-up of 2.4 years (range 0.1-12) there was no difference in primary outcome between those with AF treated with warfarin compared with NOACs ( = .35).
Conclusion: Patient with ATTR-CA and AF are at increased risk for stroke compared to patients with ATTR-CA and without AF. Thrombotic events and major bleeds did not differ between those who received warfarin and NOACs.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018530 | PMC |
| http://dx.doi.org/10.1080/13506129.2020.1810010 | DOI Listing |
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