Login
Search
Search
0 Dates
2026
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
CPC 2026
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Atrial Fibrillation in Familial Amyloid Polyneuropathy: Prevalence, Clinical Profile, and Anticoagulation Challenges
Session:
Sessão de Posters 42 - Para além da hipertrofia: as faces ocultas da doença miocárdica
Speaker:
Mariana Pereira Santos
Congress:
CPC 2026
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.10 Neurologic Disorders and Heart Disease
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Mariana Pereira Santos; Alexandra Pinto Pires; Diana Ribeiro; Pedro Monteiro; Tiago Peixoto; Ana Meireles; Marta Fontes Oliveira; Sara Lopes Fernandes; António Pinheiro Vieira; Hipólito Reis; André Luz; Patrícia Rodrigues
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Background</strong>: With longer survival, cardiac involvement, including atrial fibrillation (AFib), is increasingly recognized in familial amyloid polyneuropathy (FAP). While AFib generally warrants anticoagulation due to thromboembolic risk, the co-occurrence of transthyretin-related cerebral amyloid angiopathy (CAA) creates a dilemma due to the risk of intracranial hemorrhage. Current guidelines are extrapolated from general ATTR studies, but no dedicated data exist specifically in FAP patients.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Methods</strong>: Retrospective study of TTR V30M mutation patients, followed at a national referral center since 2019. Clinical records were reviewed for AFib occurrence, management, anticoagulation, and thrombotic or hemorrhagic events. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Results</strong>: Among 238 patients with the TTR V30M mutation, AFib occurred in 9.2% (n=22) and was more frequent in those with cardiomyopathy (27.1% vs 4.7%, p<0.001). Patients with AFib had a mean age of 66.1±13.5 years, a median disease duration of 11(IQR 8) years, were predominantly female (54.5%), and most had pacemaker implantation (86.4%). A rhythm-control strategy was used in 45.5% of patients, mostly using amiodarone (90%), whereas beta-blocker use was rare (9.1%). In half of the patients Afib was assumed permanent. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Overall, the mean CHA2DS2-VA score was 2.0±1.5, with 36.4% of patients scoring 0/1 and the majority (31.8%) scoring 3. Anticoagulation was prescribed in 77.3% (n=17), predominantly with direct-acting oral anticoagulants (DOAC) (82.4%, n=14). Antiplatelet therapy was not used in any patient. Among patients not receiving anticoagulation (22.7%), the main reasons were concern for intracranial hemorrhage due to suspected/established CAA (n=3), perceived low thromboembolic risk (n=1), and fall risk (n=1). One patient was referred for left atrial appendage closure. Notably, one patient with suspected CAA did receive anticoagulation. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">During a median follow-up of 47 months from anticoagulation initiation, only one minor gynecologic bleeding was reported. No thrombotic or major bleeding events, including intracranial hemorrhage, occurred.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion:</strong> AFib in TTR V30M FAP is relatively uncommon but associated with cardiomyopathy. While most AFib patients received anticoagulation, a subset was deferred over perceived bleeding risk. Management requires careful individualization, and the absence of major thrombotic or hemorrhagic events suggest that anticoagulation is feasible in selected real-world FAP patients. Larger, prospective studies are needed to guide optimal strategies in this population.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site