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Updated: Jan 28, 2026
Genetic Analysis of Hereditary Transthyretin Ala97Ser Related Amyloidosis
Published on: June 9, 2018
Haemorrhagic events in patients with transthyretin cardiac amyloidosis
Lucía Moreno De Redrojo Cortés1,2,3, Rocío Eiros Bachiller1,2,3, Eduardo Villacorta Argüelles1,2,3
1Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Salamanca, España.
Insights
Bleeding is common in transthyretin cardiac amyloidosis (ATTR-CA). Patients on anticoagulant therapy or with a HAS-BLED score of 2 or higher face significantly increased bleeding risks.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Transthyretin cardiac amyloidosis (ATTR-CA) is an infiltrative disease.
- Bleeding is a known comorbidity associated with ATTR-CA.
Purpose of the Study:
- To determine the incidence of bleeding in ATTR-CA patients.
- To identify risk factors contributing to bleeding in this population.
Main Methods:
- Retrospective observational study of ATTR-CA patients diagnosed between April 2016 and December 2023.
- Bleeding risk assessed using the HAS-BLED score.
- Analysis of bleeding events during follow-up.
Main Results:
- 50% of patients (91/184) experienced bleeding events, with an incidence rate of 50 bleeds per 100 patient-years.
- Anticoagulant therapy (AC) increased bleeding risk 2.5-fold (p=0.003).
- A HAS-BLED score ≥2 was associated with a 5.4-fold increase in bleeding risk (p<.001).
Conclusions:
- Bleeding is a frequent complication in ATTR-CA.
- Higher bleeding risk is observed in patients with a HAS-BLED score ≥2 and/or on anticoagulant therapy.
- Findings support consideration in risk stratification and treatment decisions for ATTR-CA patients.
Background:
transthyretin cardiac amyloidosis (ATTR-CA) is an infiltrative disease associated with several comorbidities such as Bleeding. The aim of this study was to evaluate the incidence of bleeding in patients with ATTR-CA and the underlying risk factors that promote bleeding.
Methods:
retrospective observational study of a cohort of patients with ATTR-CA diagnosed from 1st April 2016 to 31st December 2023. Bleeding risk was calculated according to HAS-BLED score and bleeding events at follow-up were analysed.
Results:
184 patients were diagnosed with a median age of 84 years [IQR 79-88], 154 (84%) males. 118 patients (64%) were on anticoagulant therapy (AC). 91 patients (50%) had a bleeding event, with a total of 189 events recorded and a median time to bleeding of 23 months [IQR 10-68]. 26 patients (29%) had severe haemorrhages and 3 patients died of haemorrhagic causes. The incidence rate was 50 bleeds per 100 patient-years and 57 per 100 patient-years in AC patients. AC resulted in a 2.5-fold raise in bleeding (95% CI 1.4-4.8; p = .003) and a score ≥2 on HAS-BLED scale in a 5.4-fold increase (95%CI 2.6-11; p < .001).
Conclusion:
bleeding is a frequent complication in ATTR-CA, with a higher risk in those individuals with a HAS-BLED score ≥2 and/or on AC. These findings could be considered in risk stratification and therapeutic decision-making.
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