The Influence of Atrial Fibrillation on Cardiac Amyloidosis
In this podcast, Temitope Ajibawo, MD, MPH, answers our questions about his team's study on how atrial fibrillation affects mortality and thromboembolic complications in patients who are hospitalized with cardiac amyloidosis, as well as the procedures these patients underwent while in the hospital.
- Ajibawo T, Okunowo O, Okunade AS. Abstract 12063: impact of atrial fibrillation on outcomes in hospitalized cardiac amyloidosis patients. Paper presented at: American Heart Association’s Scientific Sessions 2021; November 13-15, 2021; Virtual. https://www.ahajournals.org/doi/10.1161/circ.144.suppl_1.12063
Temitope Ajibawo, MD, MPH, is a fellow at the University of Arizona College of Medicine in Phoenix, Arizona.
Amanda Balbi: Hello everyone, and welcome to another installment of Podcasts360—your go-to resource for medical news and clinical updates. I’m your moderator, Amanda Balbi with Consultant360.
Today my guest is Dr Temitope Ajibawo, MD, MPH, who is a fellow at the University of Arizona College of Medicine in Phoenix, Arizona. He joins us today to talk about his team’s study on the “Impact of Atrial Fibrillation on Outcomes in Hospitalized Cardiac Amyloidosis Patients,” which he recently presented at the AHA’s Scientific Sessions 2021.
Thank you for joining us today, Dr Ajibawo. To start, can you give us an overview of your study and its findings?
Temitope Ajibawo: Okay, so the background of the study was that we wanted to see the impact of atrial fibrillation in patients who are hospitalized with cardiac amyloidosis. Especially, we were interested in mortality and thromboembolic complications and utilization of procedures while these patients were admitted into the hospital.
For our study, we did a retrospective analysis of the national impatient sample for over 8 years, between 2007 and 2014. We found that 15,811 patients were admitted during this year gap, out of which 20.6% had atrial fibrillation during their stay in the hospital. We found that these patients with atrial fibrillation had a higher mean age; they were older, and they had more comorbidities.
So, then we did a propensity score-match. We tried to mimic a randomized controlled trial so that these patients look in quality so we can compare them. After we did this, we didn't find any statistical difference in terms of hospital mortality and other outcomes, such as stroke, pulmonary embolism, or DVT. I was concerned about thromboembolic complications. We also studied sepsis and AKI.
The only significant thing we found was that the patients who had atrial fibrillation were more likely to undergo endomyocardial biopsy, specifically for cardiac amyloidosis. Sometimes when you're not sure, you might need to do a cardiac biopsy, like I said. So, these patients with atrial fibrillation were likely to undergo endomyocardial biopsy.
Those are the main findings from our story.
Amanda Balbi: Great. So how can clinicians implement your findings into clinical practice?
Temitope Ajibawo: Specifically, we had about a quarter of these patients admitted with cardiac amyloidosis still having atrial fibrillation. Atrial fibrillation has been studied in some studies, but I think the significance is that for patients admitted for cardiac amyloidosis, we should be on the lookout for arrythmia abnormalities, like atrial fibrillation. These patients need to be put on anticoagulation.
And stroke prevention measures need to be put in place for this patient very early. That's what I think translates to clinical findings.
Amanda Balbi: Absolutely. So, what is the next step in your research?
Temitope Ajibawo: Since we did a retrospective study, prospective studies need to be done. We will use types of atrial fibrillation. I only took everybody who had a trial tribulation, which is a rhythm abnormality. So, I mean we could divide them into paroxysm on that means all-cause, longstanding, persistent, or permanent. I think these are things that I would like to look into. Then, do a prospective study and see if see mortality in some years’ time, maybe 1 or 2 years, and see all those things. So, that's what I think can be done from the study.
Amanda Balbi: Great. Thank you so much for speaking with me today and answering my questions about your research.
Temitope Ajibawo: Thank you very much.