Heart failure & cardiomyopathiesSecondary analysis
Long-Term Efficacy of Tafamidis in Patients with Transthyretin Amyloid Cardiomyopathy by National Amyloidosis Centre stage
- Post-hoc analysis of the ATTR-ACT randomised trial and its long-term extension study
- subgroup analysis by baseline National Amyloidosis Centre (NAC) stage
Authors' conclusion
Tafamidis treatment reduced the risk of mortality and hospitalization in patients with NAC stages I/II ATTR-CM, with favourable trends at stage III.
Study context
- Population
- Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) in ATTR-ACT and its LTE, by baseline National Amyloidosis Centre (NAC) stage350 evaluable for NAC staging
- Participants
- 353 patients
- Comparison
- Continuous tafamidis vs placebo to tafamidis
- Primary endpoint
- All-cause mortality by NAC stage
- Follow-up
- Up to 90 months
Primary result
As reported in the abstract
All-cause mortality by baseline NAC stage · end of study
- NAC stage I: 36% vs. 61%
- HR 0.43; P < 0.001
- NAC stage II: 55% vs. 74%
- HR 0.51; P = 0.003
- NAC stage III: 69% vs. 88% (numerical trend)
- HR 0.75; P = 0.298
Further findings
Cardiovascular (CV)-related mortality by NAC stage
- Similar patterns as for all-cause mortality
CV-related hospitalizations and KCCQ-OS/CS scores by NAC stage · over follow-up
- Stages I/II: lower CV-related hospitalization rates and frequently smaller declines in KCCQ-OS/CS with continuous tafamidis; favourable trends at stage III
Original publication
Long-Term Efficacy of Tafamidis in Patients with Transthyretin Amyloid Cardiomyopathy by National Amyloidosis Centre stage. Eur J Heart Fail. Published 9 June 2025. doi:10.1002/ejhf.3696
Summarised from the published abstract; every number is checked against it