Heart failure & cardiomyopathiesSecondary analysis
Effects of Vutrisiran on Cardiac Function and Outcomes in Patients With Transthyretin Amyloidosis With Cardiomyopathy
- Secondary analysis of the HELIOS-B randomised trial
- landmark analyses
Authors' conclusion
Echocardiographic measures of biventricular systolic and diastolic function provide important prognostic information beyond National Amyloidosis Centre stage in patients with ATTR-CM. Vutrisiran improved diastolic function and attenuated declines in left ventricular and right ventricular systolic function over 18 months.
Study context
- Population
- Patients with transthyretin amyloid cardiomyopathy (ATTR-CM)654 with echocardiographic data
- Participants
- 655 patients
- Comparison
- Vutrisiran vs placebo; echocardiographic measures and outcomes
- Primary endpoint
- Associations of echocardiographic measures of cardiac structure and function with the primary outcome (all-cause death and recurrent CV events)
Primary result
As reported in the abstract
Baseline echocardiographic parameters and primary outcome (HR per unit increase)
- LVEF, per 5% increase: HR 0.90, 95% CI 0.86-0.95
- Absolute global longitudinal strain, per 1% increase: HR 0.92, 95% CI 0.89-0.96
- Tricuspid annular systolic myocardial velocity, per 1-cm/s increase: HR 0.94, 95% CI 0.90-0.98
- Average E/e', per 1-U increase: HR 1.03, 95% CI 1.01-1.04
- adjusted for age, sex, ATTR disease type and National Amyloidosis Centre stage
Further findings
| Outcome | least squares mean difference (%) (95% CI) | |
|---|---|---|
| Change in cardiac function, vutrisiran vs placebo · 18 months — Vutrisiran vs Placebo · LVEF | 1.6 (0.1–3.2) | |
| Change in cardiac function, vutrisiran vs placebo · 18 months — Vutrisiran vs Placebo · absolute global longitudinal strain | 0.7 (0.3–1.2) | |
| −2024Difference, % (linear scale) |
| Outcome | least squares mean difference (cm/s) (95% CI) | |
|---|---|---|
| Change in cardiac function, vutrisiran vs placebo · 18 months — Vutrisiran vs Placebo · tricuspid annular systolic myocardial velocity | 0.5 (0.1–0.9) | |
| −0.500.51Difference, cm/s (linear scale) |
Worsening of echocardiographic parameters at 18 months and primary outcome
- Worsening associated with heightened risk of the primary outcome
- landmark analyses
Original publication
Effects of Vutrisiran on Cardiac Function and Outcomes in Patients With Transthyretin Amyloidosis With Cardiomyopathy. J Am Coll Cardiol. Published 12 August 2025. doi:10.1016/j.jacc.2025.06.022
Summarised from the published abstract; every number is checked against it