[en] INTRODUCTION AND OBJECTIVES The two most common subtypes of cardiac amyloidosis (CA) are light-chain (AL-CA) and transthyretin (ATTR-CA). The aims of this study are to characterize both entities and analyze their prognoses. METHODS A single-centre retrospective review of CA patients diagnosed between 1998 and 2018 in Complexo Hospitalario Universitario A Coruña, with clinical follow-up until june 2019. Baseline clinical characteristics and test results were collected; survival and adverse clinical outcomes were analyzed. RESULTS There were 105 CA patients: 65 ATTR-CA and 40 AL-CA. Mean age was 74.4 years, 24.8% were women. Heart failure (HF) was the most frequent clinical presentation (55.2%) in both groups. The most prevalent electrocardiographic findings were pseudoinfarction pattern (68.5%) and Sokolow-Lyon index <1.5 mV (67.7%), with no differences between CA subtypes. After a median follow-up of 13.7 months (interquartile range 5.8-28.6 months), one, three and five-year survival were 43.3%, 40.4% and 35.4% for AL-CA patients, and 85.1%, 57.3% and 31.4% in ATTR-CA patients (p=0.004). Independent predictors of mortality were AL-CA subtype (Hazard ratio (HR) 3.41, 95% confidence interval (CI95%) 1.45-8.06, p=0.005), previous admission for HF (HR 4.25, CI95% 1.63-11.09, p=0.003) and New York Heart Association (NYHA) class III-IV (HR 2.76, CI 95%, 1.09-7.03, p=0.033). Beta-blocker therapy was associated with longer survival (HR 0.23, CI 95% 0.09-0.59, p=0.002). CONCLUSIONS Differences exist between the clinical presentation of AL-CA and ATTR-CA patients; both diseases, particularly AL-CA, are associated with poor life prognosis.

[gl] INTRODUCIÓN E OBXECTIVOS A amiloidose cardiaca (AC) por cadeas lixeiras (AC-AL) e por transtirretina (AC-ATTR) son os dous tipos máis comúns desta enfermidade. Preténdese caracterizar clínicamente ambas entidades e analizar o seu prognóstico. MÉTODOS Realizouse unha revisión retrospectiva de todos os pacientes diagnosticados de AC entre 1998 e 2018 no Complexo Hospitalario Universitario A Coruña, cun seguimento clínico ata xuño de 2019. Recolléronse as características clínicas basales e os resultados das probas complementarias ao diagnóstico; analizáronse a supervivencia e incidencia de desenlaces clínicos adversos. RESULTADOS Identificáronse 105 pacientes con AC, 65 AC-ATTR e 40 AC-AL. A idade media era de 74,4 anos; o 24,8% eran mulleres. En ambos grupos a insuficiencia cardiaca (IC) foi a forma de presentación clínica máis frecuente (55,2%). Os achados electrocardiográficos máis comúns foron o patrón de pseudoinfarto (68,5%) e un índice de Sokolow-Lyon <1,5 mV (67,7%), sen diferenzas entre os dous tipos. Despois dun seguimento mediano de 13,7 meses (rango intercuartílico 5,8-28,6 meses), a supervivencia a 1, 3 e 5 anos foi do 43,3%, 40,4% e 35,4%, respectivamente, en pacientes con AC-AL e do 85,1%, 57,3% e 31,4% en pacientes con ACATTR (p=0,004). O tipo AC-AL (Hazard ratio (HR) 3,41, intervalo de confianza ao 95% (IC95%) 1,45-8,06, p=0,005), o ingreso previo por IC (HR 4,25, IC95% 1,63-11,09, p=0,003) e unha clase New York Heart Association (NYHA) III-IV (HR 2,76, IC95% 1,09-7,03, p=0,033) foron predictores independentes da mortalidade, namentres que o tratamento betabloqueante asociouse cunha maior supervivencia (HR 0,23, IC95% 0,09-0,59, p=0,002). CONCLUSIÓNS Existen certas diferenzas na presentación clínica dos doentes con AC-AL e AC-ATTR. Ambas entidades, e moi especialmente a AC-AL, teñen un pobre prognóstico vital.