Heart failure & cardiomyopathies
Serum Transthyretin as Prognostic Biomarker for Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis
Authors' conclusion
Serum TTR is a predictor of CV events, all-cause and CV mortality, and HF across different populations, underscoring its potential use as a CV biomarker
Study context
- Population
- Diverse patient populations in longitudinal studies; 50.5% females, mean age 61.45 years, mean follow-up 41 months
- Participants
- 83,929 participants34 studies
- Comparison
- Low vs higher serum TTR levels
- Outcome
- Risk ratios for total CV events, HF, all-cause mortality and CV mortality
Methodological detailsrandom-effects model, meta-regression
- Random-effects model
- Meta-regression
Pooled result
As reported in the abstract
Low TTR vs Higher TTRHazard ratio (95% CI)P value
CV events
1.54(1.30–1.83)
P < 0.001All-cause mortality
1.65(1.50–1.82)
P < 0.001CV mortality
2.08(1.26–3.44)
P = 0.004HF
1.72(1.35–2.21)
P < 0.001Further pooled results
Risk increase per 10 mg/dL TTR decrease
- Total cardiovascular (CV)
- 30%
- All-cause mortality
- 73%
- CV mortality
- 46%
- Heart failure (HF)
- 28%
All-cause mortality, meta-regression
- Low TTR in younger male subjects, preserved EF and elevated NT-proBNP associated with higher risk of all-cause mortality
Original publication
Serum Transthyretin as Prognostic Biomarker for Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis. JACC Adv. Published 30 September 2025. doi:10.
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