Heart failure & cardiomyopathiesCohort study
Prognostic value of heart failure hospitalization in transthyretin cardiac amyloidosis: an international cohort study
- international cohort study
- multicentre TTR-CA registry
- landmark analysis at 1-year follow-up
- Cox regression with heart failure hospitalization (HFH) as a time-dependent covariate
Authors' conclusion
HFH is independently associated with all-cause mortality in patients with TTR-CA and has incremental value on top of established risk models.
Study context
- Population
- Real-world patients with transthyretin cardiac amyloidosis (TTR-CA)patients included
- Participants
- 654 patients
- Exposure
- patients were dichotomized according to the occurrence of at least one HFH
- HFHn = 141
Main finding
As reported in the abstract
Occurrence of at least one HFH and death · median follow-up of 24 (11-45) months
at least one HFH
141 (22%)
died
170 (26%)
Observational data: associations, not effects.
Further findings
All-cause mortality
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| HFH · univariable | 7.71 (5.50–10.82) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | HFH | No HFH | Estimate | P value |
|---|---|---|---|---|
| Characteristics, HFH vs no HFH | ||||
| age | 82 | 76 | ||
| wild-type TTR-CA | 126 (89.4%) | 336 (65.5%) | ||
| NYHA Class II-IV | 119 (86.9%) | 279 (62%) | ||
| disease-modifying therapy | 45 (31.9%) | 247 (47.4%) |
- Characteristics, HFH vs no HFH: age P < .001
- Characteristics, HFH vs no HFH: wild type P < .001
- Characteristics, HFH vs no HFH: NYHA P < .001
- Characteristics, HFH vs no HFH: disease-modifying therapy P = .001
Overall survival · 1-year time point
- patients with HFH had significant worse overall survival (log-rank χ²)
- 37.673
- P < .001
- landmark analysis
All-cause mortality
- HFH associated with all-cause mortality at multivariable analysis
Baseline characteristics
- median age
- 78 (64, 83) years
- male
- 70.5%
- wild type
- 70.6%
Characteristics, HFH vs no HFH
- Patients with HFH had higher National Amyloidosis Centre (NAC) disease stage, more co-morbidities and signs of more advanced disease by echocardiography
Incremental value of HFH on top of risk models
- Model 1 (estimated glomerular filtration rate) χ²
- 97.3
- Model 2 (NAC disease stage) χ²
- 78.8
- Model 3 (left ventricular mass index + stroke volume index + significant valvular lesion) χ²
- 60.3
- Model 4 (including E/e′) χ²
- 43.4
- each P < .001
Original publication
Prognostic value of heart failure hospitalization in transthyretin cardiac amyloidosis: an international cohort study. ESC Heart Fail. Published 8 January 2026. doi:10.1093/eschf/xvaf013
Summarised from the published abstract; every number is checked against it