New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact
Background: Atrial arrhythmia (AA) is common among patients with cardiac amyloidosis (CA), who have an increased risk of intracardiac thrombus. The aim of this study was to explore the prognostic impact of vitamin K-antagonists (VKA) and direct oral anticoagulants (DOAC) in patients with CA.Methods...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Frontiers Media S.A.
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/435fa4c4080545f590084dc89085847d |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:435fa4c4080545f590084dc89085847d |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:435fa4c4080545f590084dc89085847d2021-12-01T20:15:49ZNew Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact2297-055X10.3389/fcvm.2021.742428https://doaj.org/article/435fa4c4080545f590084dc89085847d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.742428/fullhttps://doaj.org/toc/2297-055XBackground: Atrial arrhythmia (AA) is common among patients with cardiac amyloidosis (CA), who have an increased risk of intracardiac thrombus. The aim of this study was to explore the prognostic impact of vitamin K-antagonists (VKA) and direct oral anticoagulants (DOAC) in patients with CA.Methods and Results: 273 patients with CA and history of AA with long term anticoagulation−69 (25%) light chain amyloidosis (AL), 179 (66%) wild-type transthyretin amyloidosis (ATTRwt) and 25 (9%) variant transthyretin amyloidosis (ATTRv)–were retrospectively included between January 2012 and July 2020. 147 (54%) and 126 (46%) patients received VKA and DOAC, respectively. Patient receiving VKA were more likely to have AL with renal dysfunction, higher NT-proBNP and troponin levels. Patients with ATTRwt were more likely to receive DOAC therapy. There were more bleeding complications among patients with VKA (20 versus 10%; P = 0.013) but no difference for stroke events (4 vs. 2%; P = 0.223), as compared to patients with DOAC. A total of 124 (45%) patients met the primary endpoint of all-cause mortality: 96 (65%) and 28 (22%) among patients with VKAs and DOACs, respectively (P < 0.001). After multivariate analysis including age and renal function, VKA was no longer associated with all-cause mortality.Conclusion: Among patients with CA and history of AA receiving oral anticoagulant, DOACs appear to be at least as effective and safe as VKAs.Eve CariouEve CariouKevin SanchisKevin SanchisKhailène RguezKhailène RguezVirginie BlanchardVirginie BlanchardVirginie BlanchardVirginie BlanchardStephanie CazalbouStephanie CazalbouPauline FournierPauline FournierAntoine HuartMurielle RousselPascal CintasMichel GalinierMichel GalinierMichel GalinierDidier CarriéDidier CarriéDidier CarriéPhilippe MauryPhilippe MauryYoan Lavie-BadieYoan Lavie-BadieYoan Lavie-BadieYoan Lavie-BadieOlivier LairezOlivier LairezOlivier LairezOlivier LairezFrontiers Media S.A.articlecardiac amyloidosisdirect oral anticoagulantsvitamin K-antagonists (VKAs)prognosisatrial arrhythmiaDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
cardiac amyloidosis direct oral anticoagulants vitamin K-antagonists (VKAs) prognosis atrial arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
cardiac amyloidosis direct oral anticoagulants vitamin K-antagonists (VKAs) prognosis atrial arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701 Eve Cariou Eve Cariou Kevin Sanchis Kevin Sanchis Khailène Rguez Khailène Rguez Virginie Blanchard Virginie Blanchard Virginie Blanchard Virginie Blanchard Stephanie Cazalbou Stephanie Cazalbou Pauline Fournier Pauline Fournier Antoine Huart Murielle Roussel Pascal Cintas Michel Galinier Michel Galinier Michel Galinier Didier Carrié Didier Carrié Didier Carrié Philippe Maury Philippe Maury Yoan Lavie-Badie Yoan Lavie-Badie Yoan Lavie-Badie Yoan Lavie-Badie Olivier Lairez Olivier Lairez Olivier Lairez Olivier Lairez New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact |
| description |
Background: Atrial arrhythmia (AA) is common among patients with cardiac amyloidosis (CA), who have an increased risk of intracardiac thrombus. The aim of this study was to explore the prognostic impact of vitamin K-antagonists (VKA) and direct oral anticoagulants (DOAC) in patients with CA.Methods and Results: 273 patients with CA and history of AA with long term anticoagulation−69 (25%) light chain amyloidosis (AL), 179 (66%) wild-type transthyretin amyloidosis (ATTRwt) and 25 (9%) variant transthyretin amyloidosis (ATTRv)–were retrospectively included between January 2012 and July 2020. 147 (54%) and 126 (46%) patients received VKA and DOAC, respectively. Patient receiving VKA were more likely to have AL with renal dysfunction, higher NT-proBNP and troponin levels. Patients with ATTRwt were more likely to receive DOAC therapy. There were more bleeding complications among patients with VKA (20 versus 10%; P = 0.013) but no difference for stroke events (4 vs. 2%; P = 0.223), as compared to patients with DOAC. A total of 124 (45%) patients met the primary endpoint of all-cause mortality: 96 (65%) and 28 (22%) among patients with VKAs and DOACs, respectively (P < 0.001). After multivariate analysis including age and renal function, VKA was no longer associated with all-cause mortality.Conclusion: Among patients with CA and history of AA receiving oral anticoagulant, DOACs appear to be at least as effective and safe as VKAs. |
| format |
article |
| author |
Eve Cariou Eve Cariou Kevin Sanchis Kevin Sanchis Khailène Rguez Khailène Rguez Virginie Blanchard Virginie Blanchard Virginie Blanchard Virginie Blanchard Stephanie Cazalbou Stephanie Cazalbou Pauline Fournier Pauline Fournier Antoine Huart Murielle Roussel Pascal Cintas Michel Galinier Michel Galinier Michel Galinier Didier Carrié Didier Carrié Didier Carrié Philippe Maury Philippe Maury Yoan Lavie-Badie Yoan Lavie-Badie Yoan Lavie-Badie Yoan Lavie-Badie Olivier Lairez Olivier Lairez Olivier Lairez Olivier Lairez |
| author_facet |
Eve Cariou Eve Cariou Kevin Sanchis Kevin Sanchis Khailène Rguez Khailène Rguez Virginie Blanchard Virginie Blanchard Virginie Blanchard Virginie Blanchard Stephanie Cazalbou Stephanie Cazalbou Pauline Fournier Pauline Fournier Antoine Huart Murielle Roussel Pascal Cintas Michel Galinier Michel Galinier Michel Galinier Didier Carrié Didier Carrié Didier Carrié Philippe Maury Philippe Maury Yoan Lavie-Badie Yoan Lavie-Badie Yoan Lavie-Badie Yoan Lavie-Badie Olivier Lairez Olivier Lairez Olivier Lairez Olivier Lairez |
| author_sort |
Eve Cariou |
| title |
New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact |
| title_short |
New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact |
| title_full |
New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact |
| title_fullStr |
New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact |
| title_full_unstemmed |
New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact |
| title_sort |
new oral anticoagulants vs. vitamin k antagonists among patients with cardiac amyloidosis: prognostic impact |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/435fa4c4080545f590084dc89085847d |
| work_keys_str_mv |
AT evecariou neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT evecariou neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT kevinsanchis neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT kevinsanchis neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT khailenerguez neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT khailenerguez neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT virginieblanchard neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT virginieblanchard neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT virginieblanchard neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT virginieblanchard neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT stephaniecazalbou neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT stephaniecazalbou neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT paulinefournier neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT paulinefournier neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT antoinehuart neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT murielleroussel neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT pascalcintas neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT michelgalinier neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT michelgalinier neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT michelgalinier neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT didiercarrie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT didiercarrie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT didiercarrie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT philippemaury neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT philippemaury neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT yoanlaviebadie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT yoanlaviebadie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT yoanlaviebadie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT yoanlaviebadie neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT olivierlairez neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT olivierlairez neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT olivierlairez neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact AT olivierlairez neworalanticoagulantsvsvitaminkantagonistsamongpatientswithcardiacamyloidosisprognosticimpact |
| _version_ |
1718404569933807616 |