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March 26, 2025IJC Heart & VasculatureOpen Access

Older age links to ~71% greater AF risk per decade in ATTR-CM alongside enlarged left atria.

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Why the study?

AF presents a treatment challenge in ATTR-CM, and there are few studies exclusively assessing factors associated with AF in these patients to guide early diagnosis and intervention.

What factors are associated with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy?

Population

273 patients with ATTR-CM with TTR mutation or wild type

Comparison

Patients with AF vs without AF

Design

Retrospective multicenter cohort study

Key result

Older age and increased left atrial diameter were independently associated with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy, with odds ratios of 1.714 and 1.631.

Authors

CRCristhian Espinoza RomeroECEdileide Barros CorreiaACAlzira De Siqueira Carvalho

Discussion

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Member takes

Overview

May inform AF surveillance in older ATTR-CM patients with enlarged LA; hypothesis-generating and leaves open causal or therapeutic implications.

Study Design

Type

Cross-Sectional (n=273)

Multicenter

Yes

Structured PICO

What factors are associated with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy?

P
Population
273 patients with transthyretin amyloidosis cardiomyopathy (ATTR-CM) with TTR mutation or wild type, median age 73 years, 73.2% male.
O
Outcome
Incidence of atrial fibrillation and associated factors

Main Result

Effect estimate: OR 1.714 (95% CI 1.143-2.571)

p-value: p=0.009

In patients with transthyretin amyloidosis cardiomyopathy, older age (≥70 years) and increased left atrial diameter (>45 mm) are significantly associated with the presence of atrial fibrillation.

Limitations

  • Cross-sectional and non-randomized design limits causal inference
  • Prevalence of AF may be underestimated due to different detection protocols across centers
  • Missing NT-proBNP and creatinine data for some patients
  • Indexed left atrial volume missing in >50% of the population
  • Time interval between echocardiogram and AF diagnosis was not standardized
  • Lack of continuous rhythm monitoring devices

Cite This Study

Romero et al. (2025) conducted a cross-sectional in Transthyretin amyloidosis cardiomyopathy (ATTR-CM) (n=273). Older age and increased left atrial diameter were independently associated with atrial fibrillation in patients with transthyretin amyloidosis cardiomyopathy, with odds ratios of 1.714 and 1.631.

synapsesocial.com/papers/6a12147dbb918b6e5b669fa4https://doi.org/10.1016/j.ijcha.2025.101658
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Uncovering predictors of atrial fibrillation in wild-type transthyretin amyloid cardiomyopathy2026
  2. 2Atrial Fibrillation Burden, Risk Factors, and Prognosis in Wild-type Transthyretin Amyloidosis Cardiomyopathy2025 · 4 citations
  3. 3Atrial Fibrillation in Transthyretin Amyloid Cardiomyopathy: A Marker of Disease Severity but Not an Independent Predictor of Mortality2026 · 1 citations
  4. 4Atrial fibrillation in amyloidotic cardiomyopathy: prevalence, incidence, risk factors and prognostic role2015 · 183 citations
  5. 5Abstract 14185: Higher Rates of Heart Failure Hospitalizations for V142I ATTR-CM Patients With Atrial Arrhythmias and Conduction Disease2022