Prevalence and outcomes of concomitant cardiac amyloidosis and coronary artery disease

Background: Cardiac amyloidosis (CA) and coronary artery disease (CAD) can have similar presentations in the acute care setting which can potentially delay the diagnosis of CA. Methods: We conducted a retrospective analysis of patients referred to our institution for evaluation of cardiac amyloidosis. We obtained demographic and clinical characteristics, laboratory data, and echocardiographic measurements of those patients with confirmed cardiac amyloidosis. The population was divided into two groups based on the presence of CAD. Frequency of heart failure hospitalizations, and one-year overall mortality were compared between both groups. Results: Between 2018 to 2021, 327 patients with suspected cardiac amyloidosis were referred to our institution. Out of 114 confirmed CA patients, 28 patients (25%) had concomitant CAD and CA. The overall mean age of CA diagnosis was 74.7 (+8.4) years for the CAD group and 69.7 (+9.8) for the non-CAD group (P value 0.002). Notably, a higher percentage of males were observed in the CAD group (92/.9% vs. 60%, p-value 0.002), and a higher prevalence of hypertension (92.9% vs 70%, p-value 0.018) and dyslipidemia (89.3% vs 59%, p-value 0.004) were also found in the CAD group. Overall, there were no significant differences in outcomes. Conclusion: Larger studies are needed to identify characteristics that will result in a prompt diagnosis of CA in patients with concomitant CAD. Although our study did not appreciate a significant difference between these two groups, outcomes of our study were likely impacted by a small sample size in the CA with CAD cohort.