{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:46:31Z","timestamp":1790621191569,"version":"4.1.0"},"reference-count":28,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cardiac amyloidosis (CA) as well as coronary artery disease (CAD) are both highly prevalent among the elderly. However, both the prevalence and risk factors associated with significant CAD among patients with CA, as well as potential outcome disparities, remain mainly unexplored. This study aimed to show the prevalence of CAD in patients with CA, as well as to assess outcomes and differences in late gadolinium enhancement (LGE) in comparison to patients with lone CA. Methods: We retrospectively assessed CA patients who underwent CAD assessment between 2013 and 2023. The primary endpoint was all-cause death. A subgroup underwent cardiac magnetic resonance imaging (CMR) with LGE assessment. Results: Of 255 consecutive patients with CA, 81 patients had significant CAD. Differences could be found with respect to age, sex, arterial hypertension, and hyperlipidemia. Significant differences in CMR features could only be found with respect to indexed left-ventricular end-diastolic volume, as well as left-ventricular mass. CAD-specific LGE was present only in 17.7% of patients with CAD, while most patients showed typical amyloid LGE, making a viability diagnosis difficult via CMR, especially in patients with end-stage CA. No differences in outcomes could be observed according to the prevalence of CAD. Conclusions: Concomitant obstructive CAD is highly prevalent among patients with CA. However, the presence of CAD does not influence patient outcomes. Furthermore, our data suggests that CAD viability testing by CMR might be complicated in patients with concomitant CA due to the high prevalence of amyloid-specific LGE.<\/jats:p>","DOI":"10.3390\/jcm14248802","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:13:33Z","timestamp":1765538013000},"page":"8802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Coronary Artery Disease in Cardiac Amyloidosis: Prevalence, Clinical Relevance, and Cardiac Magnetic Resonance Imaging Features"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6723-005X","authenticated-orcid":false,"given":"Carolina","family":"Don\u00e0","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6409-5158","authenticated-orcid":false,"given":"Ren\u00e8","family":"Rettl","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Binder-Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9597-5745","authenticated-orcid":false,"given":"Daniel","family":"Dalos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3866-3710","authenticated-orcid":false,"given":"Christina","family":"Kronberger","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6091-9823","authenticated-orcid":false,"given":"Michael","family":"Poledniczek","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Willixhofer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2744-4233","authenticated-orcid":false,"given":"Nikita","family":"Ermolaev","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Camuz-Ligios","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermine","family":"Agis","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6164-8773","authenticated-orcid":false,"given":"Matthias","family":"Koschutnik","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3179-3827","authenticated-orcid":false,"given":"Dietrich","family":"Beitzke","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2502-0676","authenticated-orcid":false,"given":"Christian","family":"Loewe","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0141-7639","authenticated-orcid":false,"given":"Christian","family":"Nitsche","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-2994","authenticated-orcid":false,"given":"Christian","family":"Hengstenberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roza","family":"Badr Eslam","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kastner","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2591-1380","authenticated-orcid":false,"given":"Jutta","family":"Bergler-Klein","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7632-9879","authenticated-orcid":false,"given":"Andreas Anselm","family":"Kammerlander","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7519-5274","authenticated-orcid":false,"given":"Franz","family":"Duca","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/eurheartj\/ehab072","article-title":"Diagnosis and treatment of cardiac amyloidosis: A position statement of the ESC Working Group on Myocardial and Pericardial Diseases","volume":"42","author":"Rapezzi","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1161\/CIRCULATIONAHA.116.021612","article-title":"Nonbiopsy Diagnosis of Cardiac Transthyretin Amyloidosis","volume":"133","author":"Gillmore","year":"2016","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1093\/eurheartj\/ehad139","article-title":"Tc-99m labelled bone scintigraphy in suspected cardiac amyloidosis","volume":"44","author":"Rauf","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Licordari, R., Trimarchi, G., Teresi, L., Restelli, D., Lofrumento, F., Perna, A., Campisi, M., de Gregorio, C., Grimaldi, P., and Calabr\u00f2, D. (2023). Cardiac Magnetic Resonance in HCM Phenocopies: From Diagnosis to Risk Stratification and Therapeutic Management. J. Clin. Med., 12.","DOI":"10.3390\/jcm12103481"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jacc.2007.10.049","article-title":"Cardiovascular Magnetic Resonance in Clinically Suspected Cardiac Amyloidosis: Noninvasive Imaging Compared to Endomyocardial Biopsy","volume":"51","author":"Vogelsberg","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3109\/13506129.2011.571319","article-title":"Myocardial infarction with \u201cclean coronaries\u201d caused by amyloid light-chain AL amyloidosis: A case report and literature review","volume":"18","author":"Tsai","year":"2011","journal-title":"Amyloid"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1002\/jmri.28314","article-title":"State of the Art: Quantitative Cardiac MRI in Cardiac Amyloidosis","volume":"56","author":"Guo","year":"2022","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1038\/labinvest.3700714","article-title":"Physical basis of colors seen in Congo red-stained amyloid in polarized light","volume":"88","author":"Howie","year":"2008","journal-title":"Lab. Investig."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/ajh.20381","article-title":"Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): A consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France, 18\u201322 April 2004","volume":"79","author":"Gertz","year":"2005","journal-title":"Am. J. Hematol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart","volume":"105","author":"Cerqueira","year":"2002","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12968-021-00827-z","article-title":"Society for Cardiovascular Magnetic Resonance (SCMR) guidelines for reporting cardiovascular magnetic resonance examinations","volume":"24","author":"Hundley","year":"2022","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1532-429X-15-92","article-title":"Myocardial T1 mapping and extracellular volume quantification: A Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement","volume":"15","author":"Moon","year":"2013","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1148\/radiology.211.3.r99jn41698","article-title":"Measurement of the distribution volume of gadopentetate dimeglumine at echo-planar MR imaging to quantify myocardial infarction: Comparison with 99mTc-DTPA autoradiography in rats","volume":"211","author":"Arheden","year":"1999","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Neumann","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jacc.2020.11.006","article-title":"Prevalence and Outcomes of Concomitant Aortic Stenosis and Cardiac Amyloidosis","volume":"77","author":"Nitsche","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1016\/j.jcin.2022.06.009","article-title":"Unveiling Cardiac Amyloidosis, its Characteristics, and Outcomes Among Patients With MR Undergoing Transcatheter Edge-to-Edge MV Repair","volume":"15","author":"Nitsche","year":"2022","journal-title":"JACC. Cardiovasc. Interv."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hassan, R., Miller, R.J.H., Howlett, J.G., White, J.A., and Fine, N.M. (2023). Prevalence, incidence and clinical outcomes of epicardial coronary artery disease among transthyretin amyloidosis cardiomyopathy patients. BMC Cardiovasc. Disord., 23.","DOI":"10.1186\/s12872-023-03140-y"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.carrev.2020.09.026","article-title":"Comparison of Patterns of Coronary Artery Disease in Patients With Heart Failure by Cardiac Amyloidosis Status","volume":"27","author":"Beyene","year":"2021","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Kaldal, A., Tonstad, S., and Jortveit, J. (2023). Association of Troponin T measurements with long-term outcomes in patients with coronary artery disease participating in a secondary prevention trial. BMC Cardiovasc. Disord., 23.","DOI":"10.1186\/s12872-023-03249-0"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1056\/NEJMoa042330","article-title":"N-Terminal Pro\u2013B-Type Natriuretic Peptide and Long-Term Mortality in Stable Coronary Heart Disease","volume":"352","author":"Kragelund","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.1182\/blood-2010-02-267708","article-title":"Assessment of disease severity and outcome in patients with systemic light-chain amyloidosis by the high-sensitivity troponin T assay","volume":"116","author":"Kristen","year":"2010","journal-title":"Blood"},{"key":"ref_22","first-page":"136","article-title":"Prognostic value of high-sensitivity cardiac troponin T in patients with endomyocardial-biopsy proven cardiac amyloidosis","volume":"11","author":"Qian","year":"2014","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1161\/CIRCULATIONAHA.108.843334","article-title":"Systemic cardiac amyloidoses: Disease profiles and clinical courses of the 3 main types","volume":"120","author":"Rapezzi","year":"2009","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1016\/j.jacc.2007.08.028","article-title":"Evaluation and Management of the Cardiac Amyloidosis","volume":"50","author":"Selvanayagam","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"C58","DOI":"10.1093\/eurheartjsupp\/suad007","article-title":"Cardiac magnetic resonance in ischemic cardiomyopathy: Present role and future directions","volume":"25","author":"Scatteia","year":"2023","journal-title":"Eur. Heart J. Suppl. J. Eur. Soc. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1016\/j.jcmg.2018.06.010","article-title":"Cardiac Magnetic Resonance T1 Mapping in Cardiac Amyloidosis","volume":"11","author":"Duca","year":"2018","journal-title":"JACC. Cardiovasc. Imaging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1161\/01.CIR.82.6.2068","article-title":"Coronary atherosclerosis is associated with left ventricular dysfunction and dilatation in aortic stenosis","volume":"82","author":"Vekshtein","year":"1990","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/ejhf.3137","article-title":"Myocardial perfusion in cardiac amyloidosis","volume":"26","author":"Chacko","year":"2024","journal-title":"Eur. J. Heart Fail."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/24\/8802\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:30:13Z","timestamp":1765539013000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/24\/8802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":28,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jcm14248802"],"URL":"https:\/\/doi.org\/10.3390\/jcm14248802","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}