fbpx Skip to main content

Patients with transthyretin amyloidosis cardiomyopathy (ATTR-CM) are at risk of cardiovascular comorbidities, including atrial fibrillation and flutter. Routine ambulatory monitoring in patients with ATTR-CM could help drive the use of anticoagulation to prevent strokes.

Heart complications, such as heart failure, are common in patients with transthyretin amyloidosis cardiomyopathy (ATTR-CM). Atrial fibrillation and flutter (AF/AFL), in particular, is a common cardiovascular comorbidity associated with ATTR-CM. However, atrial fibrillation and flutter may be overlooked in patients with ATTR-CM without a proper diagnosis. As a result, patients with ATTR-CM and AF/AFL may be at an increased risk of stroke, which needs appropriate anticoagulant treatment.

One study, published in the International Journal of Cardiology, evaluated the prevalence of AF/AFL and outcomes of routine ambulatory monitoring in patients with ATTR-CM. Healthcare providers implemented routine ambulatory ECG monitoring every six months in patients without known AF/AFL at baseline. Researchers retrieved data from an amyloidosis center of patients with wild-type or variant ATTR-CM.

Of 84 patients with ATTR-CM, 40 patients (48%) had AF/AFL before a diagnosis of ATTR-CM. Around 20 patients were diagnosed with AF/AFL after an ATTR-CM diagnosis, with 10 diagnosed based on symptoms and 11 diagnosed based on monitoring. Anticoagulation was started in 82% of patients with incidental AF/AFL. In patients receiving anticoagulation, no strokes were reported.

Due to the high prevalence of atrial fibrillation and flutter in patients with ATTR-CM, routine monitoring is a valuable aspect of care to ensure patients get preventive stroke treatment, as needed. Overlooking AF/AFL in patients with ATTR-CM could have serious consequences, as patients with ATTR-CM already face heart complications and an increased risk of hospitalization and mortality. While tafamidis is an approved medication to reduce hospitalization and mortality from ATTR-CM, anticoagulants can help reduce the risk of stroke in patients with ATTR-CM and atrial fibrillation and flutter.

You May Also Like::  Poor Sleep, Burnout Increase COVID-19 Risk in Health Care Workers

Source:
Dale, Z., Chandrashekar, P., Al-Rashdan, L., Gill, S., Elman, M., Fischer, K. L., Nazer, B., & Masri, A. (2022). Routine ambulatory heart rhythm monitoring for detection of atrial arrhythmias in transthyretin cardiac amyloidosis. International Journal of Cardiology, 358, 65-71. https://doi.org/10.1016/j.ijcard.2022.04.045

“Keeping up with the indications and adverse reactions to immune checkpoint inhibitors can be a full-time job. Cutaneous side effects occur in up to 45% of patients treated with ipilimumab and 34% of patients treated with nivolumab and pembrolizumab.” https://bit.ly/3FGtxtd

.@spfnomt: This month’s #DermWorld article “Estate planning 101” is especially important for young physicians to read. The long, all-consuming years between adolescence and physicianhood can become a blur...https://bit.ly/3FxOtCv

That’s a wrap #AAD2023! 5 days of soaking up knowledge from dermatologists on topics such as hidradenitis, melasma, & dietary triggers of common dermatoses.

I LOVED the #womenshealth focused sessions on vulvar dermatoses and pregnancy medication safety.

#dermtwitter
@AADmember

New approach uses microbiome to treat skin disease by repairing the injured microbiome that allowed inflammation to flare up in the first place, rather than reducing the inflammation after the fact. https://bit.ly/3Jt6H9v

Load More