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Atrial fibrillation emerged as a frequent and potentially prognostic complication in wild-type transthyretin amyloidosis, driven by distinct clinical risk factors.  

A study published in June 2025 issue of American Journal of Cardiology underscored the frequent occurrence of atrial fibrillation (AF) in wild-type transthyretin amyloidosis (ATTRwt) and the limited understanding of its timing, risk factors, and clinical outcomes.  

Researchers conducted a retrospective study to examine the incidence of new-onset AF, identify clinical predictors, and assess its association with all-cause mortality.  

They assessed 208 consecutive individuals diagnosed with ATTRwt between 1 January 2016 and 31 December 2022 at Aarhus University Hospital, Denmark.  

The results showed that among 208 individuals, AF was present at diagnosis in 56%. In those without AF at baseline, the cumulative incidence of new-onset AF reached 45% within 3 years (95% CI: 32–56). Multivariable Cox regression identified body mass index (BMI) (HR 1.13, 95% CI: 1.04–1.23), higher National Amyloidosis Centre (NAC) stage (HR 1.93, 95% CI: 1.14–3.27), and left ventricular mass index (LVMI) per 10-unit increase (HR 1.06, 95% CI: 1.01–1.12) as significant predictors of new-onset AF. A prior history of AF at diagnosis was linked to higher all-cause mortality but did not reach statistical significance (HR 1.74, 95% CI: 0.96–3.16, P= 0.07).  

Investigators concluded that AF was common at diagnosis and often developed after diagnosis in ATTRwt, with key risk factors including BMI, NAC stage, and LVMI, suggesting potential prognostic significance. 

Source: ajconline.org/article/S0002-9149(25)00379-0/fulltext