Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry
Introduction: Atrial fibrillation (AF) presents a treatment challenge in patients with amyloidosis cardiomyopathy, particularly in transthyretin amyloidosis cardiomyopathy (ATTR-CM). Identifying factors associated with AF is important for early diagnosis and intervention. Purpose: This study aims to...
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Elsevier
2025-06-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906725000612 |
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| author | Cristhian Espinoza Romero Edileide B. Correia Alzira De Siqueira Carvalho Ariane Vieira Scarlatelli Otavio Rizzi Coelho Filho Phillip Scheinberg Murillo De Antunes Pedro Vellosa Schwartzmann Sandrigo Mangini Wilson Marques Junior Marcus Simões Renato D. Lopes Fabio Fernandes |
| author_facet | Cristhian Espinoza Romero Edileide B. Correia Alzira De Siqueira Carvalho Ariane Vieira Scarlatelli Otavio Rizzi Coelho Filho Phillip Scheinberg Murillo De Antunes Pedro Vellosa Schwartzmann Sandrigo Mangini Wilson Marques Junior Marcus Simões Renato D. Lopes Fabio Fernandes |
| author_sort | Cristhian Espinoza Romero |
| collection | DOAJ |
| description | Introduction: Atrial fibrillation (AF) presents a treatment challenge in patients with amyloidosis cardiomyopathy, particularly in transthyretin amyloidosis cardiomyopathy (ATTR-CM). Identifying factors associated with AF is important for early diagnosis and intervention. Purpose: This study aims to identify factors linked to AF in ATTR-CM patients. Methods: The REACT registry, a retrospective, multicenter cohort study, enrolled patients with TTR mutation or wild type. ATTR-CM diagnosis was based on echocardiography and pyrophosphate scintigraphy, with some cases confirmed by biopsy. Binary logistic regression and multivariate analysis were used, with ROC curve analysis determining optimal cutoff points for continuous variables. Results: The study included 273 patients, mostly male (73.2 %), with a median age of 73 years. The ATTR variant was found in 67.3 % (165 patients), and Val142Ile was the most common variant (29.3 %). AF was present in 25.2 % (59 patients). Logistic regression revealed age (per 10-year increase) and left atrial diameter (per 5-mm increase) as predictors of AF, with odds ratios of 1.714 (p = 0.009) and 1.631 (p = 0.002), respectively. ROC curve analysis identified age ≥ 70 years and left atrium > 45 mm as optimal cutoff points (AUC 0.643 and 0.727). Conclusions: In the ATTR amyloidosis registry, older age and increased left atrium size are associated with AF. These findings may help in the early diagnosis and management of AF in ATTR-CM patients. |
| format | Article |
| id | doaj-art-02b9eb4b97184f85abb87a3e11ff0e4e |
| institution | OA Journals |
| issn | 2352-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-02b9eb4b97184f85abb87a3e11ff0e4e2025-08-20T02:31:00ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-06-015810165810.1016/j.ijcha.2025.101658Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registryCristhian Espinoza Romero0Edileide B. Correia1Alzira De Siqueira Carvalho2Ariane Vieira Scarlatelli3Otavio Rizzi Coelho Filho4Phillip Scheinberg5Murillo De Antunes6Pedro Vellosa Schwartzmann7Sandrigo Mangini8Wilson Marques Junior9Marcus Simões10Renato D. Lopes11Fabio Fernandes12Academic Research Organization, Instituto do Coracão (Incor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Corresponding author.Instituto Dante Pazzanese de Cardiologia, BrazilCentro Universitário de Saúde ABC, BrazilInstituto de Pesquisa e Innovação Tecnológica, Santa Casa de São Paulo, São Paulo, SP, BrazilHospital das Clínicas, Universidade Estadual de Campinas UNICAMP, BrazilHospital Beneficência Portuguesa de São Paulo, BrazilHospital Universitário São Francisco na Providência de Deus, BrazilCLINICOR Clínica Cardiológica Ltda, BrazilHospital Israelita Albert Einstein, BrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, BrazilHospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, BrazilDuke University Medical Center, USAAcademic Research Organization, Instituto do Coracão (Incor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilIntroduction: Atrial fibrillation (AF) presents a treatment challenge in patients with amyloidosis cardiomyopathy, particularly in transthyretin amyloidosis cardiomyopathy (ATTR-CM). Identifying factors associated with AF is important for early diagnosis and intervention. Purpose: This study aims to identify factors linked to AF in ATTR-CM patients. Methods: The REACT registry, a retrospective, multicenter cohort study, enrolled patients with TTR mutation or wild type. ATTR-CM diagnosis was based on echocardiography and pyrophosphate scintigraphy, with some cases confirmed by biopsy. Binary logistic regression and multivariate analysis were used, with ROC curve analysis determining optimal cutoff points for continuous variables. Results: The study included 273 patients, mostly male (73.2 %), with a median age of 73 years. The ATTR variant was found in 67.3 % (165 patients), and Val142Ile was the most common variant (29.3 %). AF was present in 25.2 % (59 patients). Logistic regression revealed age (per 10-year increase) and left atrial diameter (per 5-mm increase) as predictors of AF, with odds ratios of 1.714 (p = 0.009) and 1.631 (p = 0.002), respectively. ROC curve analysis identified age ≥ 70 years and left atrium > 45 mm as optimal cutoff points (AUC 0.643 and 0.727). Conclusions: In the ATTR amyloidosis registry, older age and increased left atrium size are associated with AF. These findings may help in the early diagnosis and management of AF in ATTR-CM patients.http://www.sciencedirect.com/science/article/pii/S2352906725000612AmyloidosisThromboembolismTransthyretinAtrial fibrillation |
| spellingShingle | Cristhian Espinoza Romero Edileide B. Correia Alzira De Siqueira Carvalho Ariane Vieira Scarlatelli Otavio Rizzi Coelho Filho Phillip Scheinberg Murillo De Antunes Pedro Vellosa Schwartzmann Sandrigo Mangini Wilson Marques Junior Marcus Simões Renato D. Lopes Fabio Fernandes Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry International Journal of Cardiology: Heart & Vasculature Amyloidosis Thromboembolism Transthyretin Atrial fibrillation |
| title | Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry |
| title_full | Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry |
| title_fullStr | Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry |
| title_full_unstemmed | Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry |
| title_short | Incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy: Insights from the multicenter REACT-SP registry |
| title_sort | incidence and associated factors with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy insights from the multicenter react sp registry |
| topic | Amyloidosis Thromboembolism Transthyretin Atrial fibrillation |
| url | http://www.sciencedirect.com/science/article/pii/S2352906725000612 |
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