{"id":138646,"date":"2024-11-23T01:01:44","date_gmt":"2024-11-23T06:01:44","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=138646"},"modified":"2024-11-23T01:01:44","modified_gmt":"2024-11-23T06:01:44","slug":"attr-specific-medication-and-avr-improve-survival-in-patients-with-aortic-stenosis-and-attr-cardiac-amyloidosis","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=138646","title":{"rendered":"ATTR-Specific Medication and AVR Improve Survival in Patients with Aortic Stenosis and ATTR Cardiac Amyloidosis"},"content":{"rendered":"

Key Takeaways:<\/strong><\/p>\n

    \n
  1. In this international registry, 266 patients with dual pathology, aortic stenosis and cardiac amyloidosis were identified and matched. \u00a0A control cohort of lone AS receiving aortic valve replacement was used for outcome comparison.<\/li>\n
  2. ATTR-specific medication, predominantly tafamidis, significantly improved survival in patients with dual aortic stenosis (AS) and transthyretin-associated cardiac amyloidosis (ATTR-CA) (adjusted HR 0.42; 95% CI 0.24\u20130.72), emphasizing its role in managing this complex pathology.<\/li>\n
  3. Aortic valve replacement (AVR), particularly in severe AS, provided substantial survival benefits (HR 0.42; 95% CI 0.25\u20130.72), with the combination of AVR and ATTR-specific therapy yielding outcomes comparable to lone AS patients undergoing AVR.<\/li>\n<\/ol>\n

    <\/p>\n

    Aortic stenosis (AS) and transthyretin-associated cardiac amyloidosis (ATTR-CA) often coexist in older adults, contributing to poor heart failure outcomes. The prognostic benefit of ATTR-specific medications, such as tafamidis, in combination with aortic valve replacement (AVR) has been uncertain in this population. In a multinational registry study, investigators evaluated the survival impact of ATTR-specific therapy and AVR in patients with dual AS and ATTR-CA pathology.<\/p>\n

    This multicenter, international, transatlantic registry (NCT06129331 ) included 226 patients (mean age 85\u00b16 years, 80% male) with moderate-to-severe AS diagnosed via transthoracic echocardiography and ATTR-CA confirmed by myocardial scintigraphy or biopsy. A control cohort of lone AS receiving aortic valve replacement \u00a0matched for EusoSCORE-II was used for outcome comparison. Among the cohort study , 71% underwent transcatheter AVR (TAVR), 4% had surgical AVR, 1% received balloon angioplasty, and 24% were managed conservatively. Additionally, 69 patients (31%) received ATTR-specific treatment, primarily tafamidis.<\/p>\n

    Over a median follow-up of 3.6\u00b11.7 years, all-cause mortality occurred in 50% of patients, and 26% experienced heart failure hospitalization (HHF). ATTR-specific medication independently improved survival (adjusted HR 0.42; 95% CI 0.24\u20130.72) but did not significantly affect time to first HHF. AVR was associated with improved survival overall (HR 0.63; 95% CI 0.40\u20130.99, p=0.045) and in patients with severe AS (HR 0.42; 95% CI 0.25\u20130.72, p=0.001). Patients who received both ATTR-specific treatment and AVR had the most favorable survival outcomes, comparable to a control cohort of lone AS patients undergoing AVR (log-rank, p=0.18).<\/p>\n

    These findings highlight the importance of addressing both pathologies in patients with concomitant AS and ATTR-CA, paving the way for optimizing management strategies in this challenging population.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Key Takeaways: In this international registry, 266 patients with dual pathology, aortic stenosis and cardiac amyloidosis were identified and matched. \u00a0A control cohort of lone AS receiving aortic valve replacement was used for outcome comparison. ATTR-specific medication, predominantly tafamidis, significantly improved survival in patients with dual aortic stenosis (AS) and transthyretin-associated cardiac amyloidosis (ATTR-CA) (adjusted […]<\/p>\n","protected":false},"author":40603,"featured_media":138647,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[896,8],"tags":[897,45,47,185],"ppma_author":[1029],"class_list":{"0":"post-138646","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-aha-2024","8":"category-news","9":"tag-aha-2024","10":"tag-conference","11":"tag-featured","12":"tag-news","13":"author-leah-kosyakovsky"},"authors":[{"term_id":1029,"user_id":40603,"is_guest":0,"slug":"leah-kosyakovsky","display_name":"Leah Kosyakovsky","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/864bde69f6f1f80e91e4a97f0a0ba8daa64c2bb702be09ed787444c7dfa045bb?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138646","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40603"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138646"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138646\/revisions"}],"predecessor-version":[{"id":138648,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138646\/revisions\/138648"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/138647"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138646"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138646"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138646"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138646"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}