Heart failure & cardiomyopathiesSecondary analysis
Worsening of Heart Failure in Outpatients With Transthyretin Amyloidosis and Cardiomyopathy in the APOLLO-B Trial
- Post hoc analysis of the APOLLO-B randomised trial
- double-blind and open-label extension periods
Authors' conclusion
During APOLLO-B, outpatient worsening HF in patients with transthyretin amyloidosis with cardiomyopathy was frequent, prognostic, and reduced by patisiran.
Study context
- Population
- Patients with transthyretin amyloidosis with cardiomyopathy
- Comparison
- Outpatient worsening heart failure (HF) vs none (prognosis); patisiran effect on outpatient worsening HF
- Primary endpoint
- Association of outpatient worsening HF (oral diuretic initiation or intensification) with composite of all-cause mortality and CV events
Primary result
As reported in the abstract
All-cause mortality and CV events, by outpatient worsening HF
Hazard ratio
2.21
95% CI 1.58–3.08
Outpatient worsening HF
HR 2.21 (95% CI 1.58–3.08)
- Outpatient worsening HF
- 157 (43.7%)
- No event
- 144 (40.1%)
- Urgent HF visit
- 13 (3.6%)
- Cardiovascular (CV) hospitalization
- 118 (32.9%)
- Died
- 47 (13.1%)
Further findings
Outpatient worsening HF, patisiran effect · 24 months
| Comparison | HR (95% CI) | |
|---|---|---|
| Patisiran · double-blind and open-label extension periods | 0.70 (0.51–0.96) | |
| 0.512Hazard ratio (log scale) |
Disease progression with outpatient worsening HF
- Greater deterioration in 6-minute walk distance, KCCQ-OS and NYHA class and greater increase in NT-proBNP
Patients with an event when diuretic initiation/intensification added to composite
- Increase from 141 to 215 patients
- 52%
Original publication
Worsening of Heart Failure in Outpatients With Transthyretin Amyloidosis and Cardiomyopathy in the APOLLO-B Trial. J Am Coll Cardiol. Published 22 January 2025. doi:10.1016/j.jacc.2024.10.097
Summarised from the published abstract; every number is checked against it