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American Heart Association

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Final ID: MDP1343

Optimizing the Care of Patients with Cardiac Amyloidosis in a Safety Net Hospital: A Multidisciplinary Heart Team Approach

Abstract Body (Do not enter title and authors here):
Introduction
Cardiac Amyloidosis is often underdiagnosed due to the heterogeneity of clinical presentation, disease rarity, and clinician unfamiliarity with diagnosis and management. Studies have shown that timely diagnosis and effective treatment can prolong median survival in patients with cardiac amyloidosis. By optimizing cardiovascular care, multidisciplinary heart teams play a significant role in cardiovascular disease management. We describe a multidisciplinary heart team (MDHT) based approach to the diagnosis and management of suspected cases of cardiac amyloidosis in a safety net hospital.
Methods
A MDHT working group of cardiologists, hematologists/oncologists, nuclear medicine physicians, radiologists, pathologists, nephrologists, advanced practice practitioners, and pharmacists was established to optimize the clinical care of patients with amyloidosis. Virtual monthly interdisciplinary meetings were held from January 2022 to May 2024 to review clinical cases, discuss diagnostic and treatment plans, review cardiac imaging, and implement best clinical practices to improve patient outcomes. Cases were identified based on referrals and consultations.The clinical case presentation was led by cardiology and hematology/oncology fellows. The ACC Cardiac Amyloidosis Expert Consensus Decision Pathway was used to guide management.
Results
Of the 95 patients who were suspected to have amyloidosis, 44.2% (n=42) were female, and 91.6% self-identified as Black, the median age was 70.5 years. For diagnostic testing, 32.6% (n=31) underwent a PYP scan after light chain AL amyloidosis was rulled out, and 15 patients(15.8%) underwent either cardiac or bone marrow biopsy for concerns of AL amyloidosis. Of the total cohort, 26.32% (n=25) had hereditary transthyretin amyloidosis (hATTR), and 3.16% (n = 3) had AL amyloidosis. Of the patients with confirmed amyloidosis (29.47%, n=28), 67.9% (n=19) received medical therapy [53.57% (n=15) received Tafamidis for hATTR cadiomyopathy and 7.1% (n=2) received chemotherapy for light chain AL amyloidosis.
Conclusion
A multidisciplinary heart team approach resulted in the diagnosis of cardiac amyloidosis in 26% of our cohort with 68% of the cohort receiving medical treatment. This collaboration has facilitated patient-centered care, comprehensive evaluation and personalized treatment plans for patients with suspected cardiac amyloidosis and also provided educational opportunities for trainees.
  • Stephens, Joshua  ( Morehouse School of Medicine , Atlanta , Georgia , United States )
  • Lopez, Carlos  ( Winship Cancer Institute of Emory University, , Atlanta , Georgia , United States )
  • Onuorah, Ifeoma  ( Emory University School of Medicine , Atlanta , Georgia , United States )
  • Halkar, Raghuveer  ( Emory University School of Medicine, , Atlanta , Georgia , United States )
  • Amin, Sagar  ( Emory University School of Medicine\. , Atlanta , Georgia , United States )
  • Gibson, Briana  ( Emory University School of Medicine , Atlanta , Georgia , United States )
  • Bernal-mizrachi, Leon  ( Winship Cancer Institute of Emory University, , Atlanta , Georgia , United States )
  • Ogunniyi, Modele  ( Emory University School of Medicine , Atlanta , Georgia , United States )
  • Olakunle, Oreoluwa  ( Emory University School Of Medicine , Atlanta , Georgia , United States )
  • Crawford, Kaylyn  ( Emory University School Of Medicine , Atlanta , Georgia , United States )
  • Guynn, Nicole  ( Emory University School of Medicine , Atlanta , Georgia , United States )
  • Ford, Dimitri  ( Morehouse School of Medicine , Atlanta , Georgia , United States )
  • Brown, Matthew  ( Emory University School of Medicine , Atlanta , Georgia , United States )
  • Works, Faith  ( Grady Health System , Atlanta , Georgia , United States )
  • Taylor, Deborah  ( Grady Health System , Atlanta , Georgia , United States )
  • Cheeley, Mary Katherine  ( Grady Health System , Atlanta , Georgia , United States )
  • Author Disclosures:
    Joshua Stephens: DO NOT have relevant financial relationships | Carlos Lopez: No Answer | ifeoma Onuorah: No Answer | Raghuveer Halkar: No Answer | Sagar Amin: DO NOT have relevant financial relationships | Briana Gibson: DO NOT have relevant financial relationships | Leon Bernal-Mizrachi: No Answer | Modele Ogunniyi: DO have relevant financial relationships ; Research Funding (PI or named investigator):AstraZeneca:Active (exists now) ; Consultant:Novartis (Clinical Trial Steering Committee):Active (exists now) ; Research Funding (PI or named investigator):Cardurion Pharmaceuticals:Past (completed) ; Research Funding (PI or named investigator):Boerhinger Ingelheim:Past (completed) ; Research Funding (PI or named investigator):Pfizer:Active (exists now) | Oreoluwa Olakunle: DO NOT have relevant financial relationships | Kaylyn Crawford: DO NOT have relevant financial relationships | Nicole Guynn: DO NOT have relevant financial relationships | Dimitri Ford: DO NOT have relevant financial relationships | MATTHEW BROWN: No Answer | FAITH WORKS: No Answer | Deborah Taylor: No Answer | Mary Katherine Cheeley: DO have relevant financial relationships ; Consultant:Novartis:Active (exists now)
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Improving Detection of Transthyretin Cardiac Amyloidosis

Monday, 11/18/2024 , 11:10AM - 12:35PM

Moderated Digital Poster Session

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