Impact of Tafamidis on survival in elderly patients: Insights from the Healthcare European Amyloidosis Registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Cardiac transthyretin amyloidosis (ATTR-CM) is a life-threatening cardiomyopathy. Tafamidis has been demonstrated to be an effective treatment. Our aim was to analyze clinical characteristics and survival of patients with ATTR-CM aged ≥80 years diagnosed after November 2018, treated with tafamidis 80/61 mg, and compare them with a non-treated group diagnosed before that date. METHODS: Data from the two groups were extracted from the Healthcare European Amyloidosis Registry (HEAR). Propensity score matching was used to adjust for baseline differences between the groups. Kaplan-Meier survival curves and Cox regression analyses were applied to assess survival outcomes. RESULTS: Out of 1380 patients, 1194 were treated with tafamidis 80/61 mg. Treated patients were significantly less severe at baseline, with a lower occurrence of NYHA class III-IV compared to the untreated group (24 vs. 46 %, p < 0.001). The median NT-proBNP at baseline was lower in the treated group (2330 vs. 4854 pg/ml, p < 0.001), as was the average level of high-sensitivity troponin T (55 vs. 74 ng/ml, p < 0.001), and the interventricular septal thickness (16 vs. 18 mm, p < 0.001). The 3-year survival rate for treated patients was 57 %, and 40 % for untreated patients. In the treated group, the 3-year survival rate was 68 % for patients aged 80-85 years and 58 % for those over 85 years. Survival rates were confirmed after propensity score analyses. CONCLUSIONS: This study demonstrates that tafamidis provides significant survival benefits for elderly patients with ATTR-CM, even in those over 85 years old. The findings emphasize the importance of early diagnosis and treatment.
Authors: Antoine Jobbé-Duval, Mounira Kharoubi, Erwan Donal, Fabrice Bauer, Amaury Broussier, Arnaud Bisson, Océane Bouchot, Phillipe Charron, Jérôme Costa, Pierre-Yves Courand, Charlotte Dagrenat, François Delelis, Jean-Christophe Eicher, Antoine Fraix, Barnabas Gellen, Jean-Pierre Gueffet, Gilbert Habib, Jocelyn Inamo, Julien Jeanneteau, Damien Legallois, Léa Margerit, Basile Mouhat, Nicolas Piriou, Tania Puscas, Patricia Réant, François Roubille, Romain Trésorier, Jean-Jacques Von Hunolestein, Charles Taieb, Amira Zaroui, Olivier Lairez, Thibaud Damy
Institutions: Hospices Civils de Lyon, Hôpital Louis Pradel, Inserm, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Laboratoire Traitement du Signal et de l'Image, Centre Hospitalier Universitaire de Rennes, Université de Rennes, Assistance Publique – Hôpitaux de Paris, Bicêtre Hospital, Université Paris-Est Créteil, Hôpital Émile-Roux, Institut Mondor de Recherche Biomédicale, Centre Hospitalier Universitaire de Tours, Centre Hospitalier Annecy Genevois, Sorbonne Paris Cité, Pitié-Salpêtrière Hospital, Paris Cardiovascular Research Center, Université Paris Descartes, Centre Hospitalier Universitaire de Reims, Lyon 1 Université, Centre National de la Recherche Scientifique, Université de Lyon, Hôpital de la Croix-Rousse, Hôpital Lyon Sud, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé, Institut National des Sciences Appliquées de Lyon, Groupe Hospitalier de l'Institut Catholique de Lille, CHU Dijon Bourgogne, Centre Hospitalier Régional et Universitaire de Nancy, Hôpital privé du Confluent, Assistance Publique Hôpitaux de Marseille, Hôpital de la Timone, Centre Hospitalier Universitaire de Martinique, Centre Hospitalier Universitaire de Caen Normandie, Groupe Hospitalier Mutualiste de Grenoble, Centre Hospitalier Universitaire de Besançon, Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Nantes Université, Centre Hospitalier Universitaire de Bordeaux, Université de Montpellier, Physiologie et Médecine Expérimentale du Coeur et des Muscles, Centre Hospitalier Universitaire de Montpellier, Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpitaux Universitaires de Strasbourg, Centre Hospitalier Universitaire de Toulouse
Language: English
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $3,970
OpenAlex ID: W4411334473