Heart failure & cardiomyopathiesSecondary analysis
Atrial Fibrillation as a Prognostic Factor for All-Cause Mortality in Patients With Transthyretin Amyloid Cardiomyopathy
- Secondary analysis of the ATTR-ACT randomised trial
- Cox proportional hazards modelling
Authors' conclusion
In ATTR-ACT, baseline or historical AF/AFL was prognostic for all-cause mortality in analyses with limited adjustment but not after accounting for additional indicators of disease severity. Baseline or historical AF/AFL did not impact the efficacy of tafamidis treatment.
Study context
- Population
- Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) in ATTR-ACT (tafamidis vs placebo); median age 75 years, 90% male
- Participants
- 441 patients
- Comparison
- Baseline or historical AF/AFL vs none
- AF/AFLn = 314
- Primary endpoint
- All-cause mortality
- Follow-up
- 30 months
Primary result
As reported in the abstract
Hazard ratio
0.550
95% CI 0.368–0.821
AF/AFL
HR 0.550 (95% CI 0.368–0.821)
Further findings
Interaction tafamidis treatment × AF/AFL
- All-cause mortality interaction, not significant
- P = 0.33
- KCCQ Overall Summary score change interaction, not significant
- P = 0.83
- 6-minute walk test distance change interaction, not significant
- P = 0.82
Prognostic factors in expanded stepwise model
- Blood urea nitrogen, NT-proBNP, 6-minute walk distance, genotype, treatment and global longitudinal strain prognostic
- P < 0.01
Original publication
Atrial Fibrillation as a Prognostic Factor for All-Cause Mortality in Patients With Transthyretin Amyloid Cardiomyopathy. JACC CardioOncol. Published 30 April 2024. doi:10.1016/j.jaccao.2024.03.007
Summarised from the published abstract; every number is checked against it