TY  - BOOK
AU  - Beyene, Solomon
AU  - Brathwaite, Echo
AU  - Dan, Kazuhiro
AU  - Garcia-Garcia, Hector M
AU  - Hideo-Kajita, Alexandre
AU  - Kadakkal, Ajay
AU  - Kuku, Kayode
AU  - Melaku, Gebremedhin
AU  - Mohammed, Selma
AU  - Sheikh, Farooq
AU  - Wilson, Vanessa
AU  - Yacob, Omar
TI  - Comparison of Patterns of Coronary Artery Disease in Patients With Heart Failure by Cardiac Amyloidosis Status
SN  - 1878-0938
PY  - 2021///
KW  - *Amyloidosis
KW  - *Coronary Artery Disease
KW  - *Heart Failure
KW  - Aged
KW  - Aged, 80 and over
KW  - Amyloidosis/dg [Diagnostic Imaging]
KW  - Amyloidosis/di [Diagnosis]
KW  - Coronary Angiography
KW  - Coronary Artery Disease/co [Complications]
KW  - Coronary Artery Disease/dg [Diagnostic Imaging]
KW  - Coronary Artery Disease/ep [Epidemiology]
KW  - Female
KW  - Heart Failure/dg [Diagnostic Imaging]
KW  - Heart Failure/ep [Epidemiology]
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Retrospective Studies
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Journal Article
N2  - BACKGROUND/PURPOSE: The aim of this study is to characterize the pattern and the severity of coronary artery lesions in cardiac amyloidosis; CONCLUSIONS: Overall, heart failure patients with cardiac amyloidosis were older but were found to have less calcified lesions, less ostial involvement, and a reduced anterograde coronary blood flow. This is the first report examining coronary lesions in heart failure patients with cardiac amyloidosis; METHODS: We retrospectively compared patients with heart failure who were tested positive (i.e., biopsy or gene tests - HF/CA+) against those who tested negative (HF/CA-) for cardiac amyloidosis. Groups were compared demographically and angiographically for qualitative and quantitative variables to determine patterns of involvement in the major epicardial coronary vessels; RESULTS: The study included 110 heart failure patients, of whom, 55 patients (88 lesions) were in the HF/CA+ group, and 55 patients (66 lesions) were HF/CA-. Despite the advanced age of HF/CA+ patients (74.5 +/- 11.0 years vs. 54.1 +/- 15.0 years; p = 0.05), no severe calcification was found in the HF/CA+ group (0.0% vs. 4.5%; p = 0.018). The HF/CA+ group also had fewer ostial lesions (3.4% vs. 15.1%; p = 0.0095) and a higher, albeit not significant, Thrombolysis in Myocardial Infarction frame count (30.4 +/- 12.6 vs. 26.6 +/- 11 frames; p = 0.06). In the HF/CA+ group, men had a significant number of tandem lesions compared to women (14.5% vs 0.0%, p = 0.02); SUMMARY: Previous studies have shown the involvement of amyloid in cardiac tissue and vasculature, as various methods to determine the deposition of the protein have been studied. However, the pattern or severity of disease in the coronary vasculature using coronary angiography has not yet been investigated. Patients with heart failure and cardiac amyloidosis had numerous lesions in the coronaries that were less calcified with less ostial involvement and reduced anterograde blood flow compared to amyloid-negative heart failure patients. Copyright (c) 2020 Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.carrev.2020.09.026
ER  -