PDF(Pubmed)
Abstract：
Cardiac amyloidosis (CA) involves the abnormal deposition and accumulation of amyloid proteins in the heart muscle. A hallmark of disease progression is declining heart function, which can lead to structural irregularities, arrhythmias, and ultimately heart failure. Atrial fibrillation (AF) is the most common arrhythmia that presents in CA patients, and this arrhythmia is significant because it can moderately increase the risk of patients developing intracardiac thrombi, thereby putting them at risk for thromboembolic events. The management of this complication entails the use of anticoagulants like vitamin K antagonists and direct oral anticoagulants to reduce the risk of thrombus formation. This article seeks to review AF in CA and the use of anticoagulation therapy for the management and reduction of thromboembolic risk. The major conclusions of this review are centered around the need for safe administration of anticoagulant therapy to CA patients, regardless of their CHA2DS2-VASc risk score. This review highlights the importance of taking a multidisciplinary or collaborative approach to CA treatment to ensure that all aspects of this multifaceted disease can be properly managed while minimizing adverse events like bleeding risk and drug-drug interactions.
摘要：
心脏淀粉样变性（CA）涉及心肌中淀粉样蛋白的异常沉积和积累。疾病进展的一个标志是心脏功能下降，这可能导致结构不规则，心律失常,最终导致心力衰竭。心房颤动（AF）是CA患者中最常见的心律失常，这种心律失常很重要，因为它可以适度增加患者发生心内血栓的风险，从而使他们面临血栓栓塞事件的风险。这种并发症的处理需要使用抗凝剂如维生素K拮抗剂和直接口服抗凝剂来降低血栓形成的风险。本文旨在回顾CA中的AF以及抗凝治疗在控制和降低血栓栓塞风险方面的应用。本综述的主要结论集中在对CA患者进行安全的抗凝治疗的需要。无论他们的CHA2DS2-VASc风险评分如何。这篇综述强调了采取多学科或协作方法治疗CA的重要性，以确保这种多方面疾病的所有方面都能得到适当管理，同时最大限度地减少出血风险和药物相互作用等不良事件。
