Tafamidis beneficial in geriatric transthyretin cardiac amyloidosis

Treatment with the transthyretin stabilizer tafamidis helps lower mortality and reduce hospital readmissions for acute heart failure in octogenarian patients with transthyretin cardiac amyloidosis, as shown in a study.

The study included 465 older patients (median age 86 years, 80 percent men, 78 percent White) with confirmed transthyretin cardiac amyloidosis (hereditary or wild‐type) who were followed at the French Referral Center. Of the patients, 282 were treated with tafamidis for at least 24 months and 183 did not receive the medication (control).

The primary outcome was 24‐month all‐cause death. Secondary outcomes included hospital readmission for acute heart failure at 12 months and the causes of death.

At baseline, more patients in the tafamidis than the control group had hypertension (p=0.003). No significant between-group differences were observed in the other cardiovascular risk factors. NYHA class was II in half of the patients and III in 34 percent. Overall, 28 percent of patients had orthostatic hypotension, and 41 percent had atrial fibrillation.

Compared with the control group, the tafamidis group had a 56-percent lower risk of all-cause death at 24 months (hazard ratio [HR], 0.44, 95 percent confidence interval [CI], 0.35–0.57; p<0.001).

Tafamidis was also associated with a 35-percent reduction in the frequency of hospital readmissions for acute heart failure at 12 months compared with control (HR, 0.65, 95 percent CI, 0.48–0.90; p=0.008). No significant between-group difference was observed in the incidence of cardiovascular deaths.