Heart failure & cardiomyopathiesCohort study
Determinants and Clinical Interpretation of Circulating Transthyretin in ATTR Amyloidosis
- single-center cohort
Authors' conclusion
Circulating TTR reflects the integrated effects of systemic status and therapeutic interventions and should not be interpreted as a simple surrogate of ATTR disease severity.
Study context
- Population
- Patients with ATTRpatients enrolled, baseline TTR in 91 treatment-naive patients, 347 longitudinal measurements
- Participants
- 134 patients
Main finding
As reported in the abstract
Baseline TTR levels across clinical stages · baseline
Observational data: associations, not effects.
Further findings
Determinants of TTR levels (longitudinal mixed-effects analyses)
- older age, β (lower TTR)
- −0.310, P < 0.001
- inflammation (log10[C-reactive protein+0.1]), β (lower TTR)
- −6.011, P < 0.001
- cardiac stress (log10BNP), β (lower TTR)
- −1.460, P = 0.033
- albumin, β (positively associated)
- 3.041; P < 0.001
- Wild-type ATTR vs variant ATTR, β (higher TTR)
- 6.766; P < 0.001
- Tetramer stabilizers, β (increased TTR)
- 8.095; P < 0.001
- small-interfering RNA therapy, β (reduced TTR)
- −13.456; P < 0.001
- independently associated
Median TTR following stabilizer initiation · >730 days of therapy
mg/dL
- median TTR before
- 21.5
- median TTR after >730 days
- 32.2
Original publication
Determinants and Clinical Interpretation of Circulating Transthyretin in ATTR Amyloidosis. JACC Adv. Published 23 July 2026. doi:10.1016/j.jacadv.2026.103047
Summarised from the published abstract; every number is checked against it