Heart failure & cardiomyopathiesCohort study
Contemporary real-world treatment of cardiac transthyretin amyloidosis with tafamidis: a long-term multicentre study
- retrospective, multicentre study
- propensity-score matching for age, New York Heart Association (NYHA) class, National Amyloidosis Centre (NAC) stage, and serum albumin
Authors' conclusion
This study provides long-term real-world outcome data for ATTR-CM patients treated with tafamidis based on physician clinical judgement. Adverse outcomes were strongly predicted by low serum albumin, advanced NAC stage, and older age, emphasizing the importance of early diagnosis and timely therapy of ATTR-CM.
Study context
- Population
- ATTR-CM patients enrolled after commercial availability of tafamidis 61 mg in Germany (April 2020 to March 2021), with treatment initiation based on physician clinical judgementmedian age 80 [76–83] years, 85% male and 8% variant ATTR, 80% received tafamidis
- Participants
- 329 patients
- Exposure
- tafamidis vs no tafamidis
- Outcome
- All-cause mortality
- Follow-up
- Median 39 [18-48] months
Main finding
As reported in the abstract
Hazard ratio
0.28
95% CI 0.13–0.61
P = 0.001
tafamidis vs no tafamidis
HR 0.28 (95% CI 0.13–0.61); P = 0.001
- Patients who died (whole cohort)
- 21%
- 3-year survival, tafamidis-treated patients
- 86%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Composite of all-cause mortality and/or HF hospitalization (secondary endpoint) · median follow-up 39 [18-48] months | 0.56 (0.33–0.97) | P = 0.039 | |
| 0.20.5125Hazard ratio (log scale) |
- Composite of all-cause mortality and/or heart failure (HF) hospitalization (secondary endpoint) — Patients reaching the composite endpoint (whole cohort)
- 42%
- Composite of all-cause mortality and/or HF hospitalization (secondary endpoint) — 3-year event-free survival, tafamidis-treated patients
- 63%
- Composite of all-cause mortality and/or HF hospitalization (secondary endpoint): fewer composite events with tafamidis; after propensity-score matching
Predictors of primary and secondary endpoints in tafamidis-treated patients
- advanced NAC stage (primary; secondary)
- P < 0.031; P < .009
- age ≥80 years (primary; secondary)
- P = 0.022; P = .004
- serum albumin ≤42.5 g/L (primary; secondary)
- P = 0.015; P < .001
- NYHA class ≥III predicted only the composite endpoint (primary; secondary)
- P = 0.059; P < .001
Original publication
Contemporary real-world treatment of cardiac transthyretin amyloidosis with tafamidis: a long-term multicentre study. ESC Heart Fail. Published 30 July 2026. doi:10.1093/eschf/xvag211
Summarised from the published abstract; every number is checked against it