| Autor: |
Ghoneem, Ahmed, Bhatti, Ammar W, Mitchell, Joshua D, Liu, Jennifer, Zhang, Kathleen, Trachtenberg, Barry, Wechalekar, Ashtoush, Cheng, Richard, Baron, Suzanne J, Nohria, Anju, Lenihan, Daniel, Dani, Sourbha, Ganatra, Sarju |
| Zdroj: |
Circulation (Ovid); November 2022, Vol. 146 Issue: Supplement 1 pA13273-A13273, 1p |
| Abstrakt: |
Background:Tafamidis was associated with reduction in cardiovascular hospitalizations and all-cause mortality in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) in the ATTR-ACT trial. However, real-world data on the efficacy of tafamidis are limited.Methods:We conducted a retrospective, observational cohort study using the TriNetX research network, a multicenter federated research network with data pooled from electronic health records. Patients with wild-type TTR amyloidosis and heart failure (HF) were identified based on ICD-10 codes on or before May 15, 2021. The study cohort was then divided into two groups based on treatment with tafamidis. Propensity score matching (PSM) was performed to balance the confounders. Rates of heart failure exacerbations (HFE) and all-cause mortality at 12 months were compared between the two cohorts.Results:We identified 1362 patients with wild-type ATTR amyloidosis with HF (tafamidis group =553, non-tafamidis group =809). After PSM, there were 421 patients in each group (mean age: 76 years, Female 14%, White race 64%). During the 12-month follow-up period, 38 (9.0%) patients experienced HFE in the tafamidis group compared to 58 (13.8%) patients in the non-tafamidis group (OR 0.62; CI0.40-0.95, p=0.030). Patients treated with tafamidis had lower all-cause mortality compared to the non-tafamidis group (10.7% vs. 16.4%; OR 0.61, CI 0.40-0.91, p=0.016). The treated cohort had a higher probability of event-free survival for HFE (HR 0.61; 95% CI 0.40-0.92, Log-Rank p= 0.018) and all-cause mortality (HR 0.619; 95% CI 0.425, 0.901, Log-Rank p= 0.011).Conclusion:This real-world analysis confirms that tafamidis use is associated with reduced HF exacerbations and all-cause mortality in patients with wild-type TTR amyloidosis and HF. Longer term follow-up is needed to better understand the utility of tafamadis given the increasing recognition of ATTR-CM and its high cost. |
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