Valvular & structural heart diseaseCohort study
Cardiac transthyretin amyloidosis treatment improves outcomes after aortic valve replacement for severe stenosis
- Registry study (multicentre international cohort)
- 16 centres across 10 countries
- weighted analysis
- EuroSCORE II-matched control cohort
Authors' conclusion
ATTR-specific treatment and AVR both result in significant survival benefit in dual pathology AS and ATTR-CA.
Study context
- Population
- Patients with concomitant significant (moderate/severe) aortic stenosis (AS) and ATTR-CA
- Participants
- 226 patients · 16 centres · 10 countries
- Exposure
- ATTR-specific medication vs no ATTR medication
- ATTR medicationn = 69
- Outcome
- All-cause and CV mortality and hospitalisation for HF
- Follow-up
- 3.6 ± 1.7 years
Main finding
As reported in the abstract
Mortality
ATTR medication vs No ATTR medicationWeighted hazard ratio (95% CI)
all-cause mortality
0.40(0.24–0.68)
CV mortality
0.47(0.27–0.83)
- Deaths overall
- 112 (49.6%)
- Cardiovascular (CV) deaths
- 89 (79.5%)
- Hospitalisation for heart failure (HHF) overall
- 58 (25.7%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Survival with AVR — AVR vs No ATTR medication · overall cohort | 0.60 (0.39–0.93) | |
| Survival with AVR — AVR vs No ATTR medication · severe AS cohort | 0.42 (0.26–0.70) | |
| 0.20.5125Hazard ratio (log scale) |
ATTR medication plus aortic valve replacement (AVR)
- Most favourable prognosis, comparable to lone AS control cohort undergoing AVR
Original publication
Cardiac transthyretin amyloidosis treatment improves outcomes after aortic valve replacement for severe stenosis. Eur Heart J. Published 2 June 2025. doi:10.1093/eurheartj/ehaf362
Summarised from the published abstract; every number is checked against it