Observational studyEuropean heart journal2025
Cardiac transthyretin amyloidosis treatment improves outcomes after aortic valve replacement for severe stenosis.
Observational study in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06129331 (Aortic Stenosis and Cardiac Amyloidosis), which is not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Aortic Stenosis and Cardiac Amyloidosis: A Pragmatic, Streamlined International
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Real-world effectiveness of targeted therapies in ATTR cardiomyopathy: A meta-analysis integrating population-based data.ESC heart failure · 2025Pooled it
- Cardiac amyloidosis: what every interventional cardiologist should know.Cardiovascular intervention and therapeutics · 2026Review
- Dual pathology in aortic stenosis: Identifying transthyretin amyloidosis likelihood in patients referred for transcatheter aortic valve implantation.International journal of cardiology. Heart & vasculature · 2026Article
- The biological interplay between aortic stenosis and transthyretin cardiac amyloidosis.European heart journal. Case reports · 2026Article
- Prognostic Thresholds of Tricuspid Regurgitation in Transthyretin Amyloid Cardiomyopathy.JAMA cardiology · 2026Article
- Myocardial remodeling in valvular heart disease: pathophysiology, multimodality imaging and treatment implications.Heart failure reviews · 2026Review
- Low-Flow, Low-Gradient Aortic Stenosis in Transthyretin Cardiac Amyloidosis: Diagnostic and Therapeutic Challenges-A Case Report.Diagnostics (Basel, Switzerland) · 2026Article
- Long-Term Outcomes of Targeted Volume Overload Management in Patients With Severe Aortic Stenosis.JACC. Advances · 2026Article
- Prognostic Value of Artificial Intelligence-Enabled Electrocardiography-Derived Diastolic Dysfunction Grading and Trajectory in Patients Undergoing Transcatheter Aortic Valve Replacement.Journal of the American Heart Association · 2026Article
- Risk-score performance for detecting transthyretin cardiac amyloidosis in severe aortic stenosis: a prospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Aortic stenosis: need for treatment of co-existent cardiac amyloidosis?European heart journal · 2025Article
- The Weight of Comorbidities in the Specific Treatment of ATTR-Related Amyloid Cardiomyopathy.Current cardiology reports · 2025Review
- Intravenous Treprostinil in Precapillary and Postcapillary Pulmonary Hypertension Due to Cardiac Amyloidosis and Aortic Stenosis.JACC. Case reports · 2025Article
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
BACKGROUND AND
aimsConcomitant aortic stenosis (AS) and transthyretin-associated cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of structural heart failure. Aortic valve replacement (AVR) improves prognosis in this population, but the efficacy of ATTR-specific medication remains unclear. This study aimed to investigate the prognostic implications of ATTR-specific medication in patients with dual AS-CA.
methodsThis is a multicenter, international, transatlantic registry of patients with a concomitant pathology of significant AS (moderate/severe) and ATTR-CA (ClinicalTrials.gov identifier: NCT06129331). AS severity was diagnosed by transthoracic echocardiography and ATTR-CA by myocardial uptake on bone scintigraphy and/or positive endomyocardial biopsy in the absence of monoclonal proteins. Mortality [all-cause and cardiovascular (CV)] and hospitalisation for heart failure (HHF) served as clinical endpoints. Outcomes were compared with a control cohort of confirmed lone AS receiving AVR matched for EuroSCORE II.
resultsOf 226 patients with dual pathology (85 ± 6 years, 80.4% male) identified in 16 centres across 10 countries, AS was severe in 196 (86.7%), and moderate in 30 (13.3%). Valve treatment strategies were transcatheter/surgical AVR in 71.7%/3.5%, balloon angioplasty in 1.3%, and conservative management in 23.5%. Seventy-three patients (32.3%) were prescribed, and 69 patients (30.5%) eventually received ATTR-specific medication (99% tafamidis) and were younger, with lower EuroSCORE II, a higher portion of moderate AS, but higher interventricular septum thickness and more severely impaired left ventricular function compared with patients without ATTR medication. After 3.6 ± 1.7 years, 112 (49.6%) had died [CV death: 89 (79.5%)] and 58 (25.7%) experienced HHF. ATTR-specific medication was independently associated with lower all-cause [weighted hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.24-0.68] and CV mortality (weighted HR 0.47, 95% CI 0.27-0.83) but not HHF. AVR improved survival in the overall (HR 0.60, 95% CI 0.39-0.93) and severe AS cohort (HR 0.42, 95% CI 0.26-0.70). Patients who received both ATTR-specific medication and AVR had the most favourable prognosis, comparable to a control cohort with lone AS undergoing AVR.
conclusionsATTR-specific treatment and AVR both result in significant survival benefit in dual pathology AS and ATTR-CA. Results should be interpreted in the context of the non-randomized study setting and differences in patient characteristics.
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