Trends, Associations, and Impact of Atrial Fibrillation in Patients With Light-chain Cardiac Amyloidosis. Issue 3 (17th February 2021)

• Record Type: Journal Article
• Authors: Abe, Temidayo; Olanipekun, Titilope; Khoury, Mtanis; Egbuche, Obiora; Effoe, Valery; Ghali, Jalal
• Is Part Of: Critical pathways in cardiology. Volume 20:Issue 3(2021)
• Page Start: 168
• Page End: 172
• Publication Date: 2021-02-17
• Subjects: atrial fibrillation -- cardiomyopathy -- light-chain cardiac amyloidosis; Cardiology -- Periodicals; Evidence-based medicine -- Periodicals; Medical protocols -- Periodicals; 616.12005
• DOI: 10.1097/HPC.0000000000000257
• Languages: English
• ISSNs: 1535-282X

Abstract

Abstract : Supplemental Digital Content is available in the text. Abstract : Background: In this study, we investigated the temporal trends in the prevalence and prognostic implication of atrial fibrillation (AF) in patient with light-chain cardiac amyloidosis (AL-CA). Methods: We identified 3030 patients with AL-CA from the 2015 to 2017 National Inpatient Sample, of which 1577 (52%) had AF. We used trend analysis to assess the temporal trends in the prevalence of AF by subtype from 2015 to 2017. We compared inhospital mortality, acute on chronic heart failure, stroke, length of stay (LOS), and total cost in patients with to those without AF, stratified by subtype of AF. Results: The prevalence of AF among patients with AL-CA was unchanged from 2015 to 2017 (50%–53%; adjusted odds ratio, 1.1 [0.9–1.5]; P = 0.3). The trend was unchanged in the stratified analysis by subtype of AF. Patients with AF were older and had more comorbidities. After propensity matching, acute on chronic heart failure was significantly higher in patients with AL-CA and AF, compared with those with AL-CA alone (55.6% vs. 48.3%; P < 0.0001). There was no difference in inhospital mortality (7.5% vs. 7.5%; P = 0.9), stroke (2.0% vs. 2.5%; P = 0.5), median LOS (5 [3–9] vs. 5 [3–8]; P = 0.3), and median total hospital cost $42, 469 ([$21, 309–$92, 855] vs. $44, 008 [$22, 889–$94, 200]; P = 0.6). In the stratified analysis, acute on chronic heart failure remained significant higher in patients with paroxysmal and nonparoxysmal AF, while LOS became significantly longer in patients with paroxysmal AF. Conclusions: Among patients with AL-CA, AF is associated with a higher risk of acute on chronic heart failure.