Causes of Cardiovascular Hospitalization and Death in Patients With Transthyretin Amyloid Cardiomyopathy (from the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial [ATTR-ACT])
Causes of Cardiovascular Hospitalization and Death in Patients With Transthyretin Amyloid Cardiomyopathy (from the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial [ATTR-ACT])
复制标题
DOI：
10.1016/j.amjcard.2021.02.035
复制
发表时间：
2021-05-06
影响因子：
2.8
通讯作者：
Lopez-Sendon, Jose
中科院分区：
文献类型：
--
作者：
Miller, Alan B.;Januzzi, James L.;Lopez-Sendon, Jose
在转甲状腺素蛋白心肌病临床试验 (ATTR-ACT) 中，Tafamidis 与安慰剂相比，显着降低了转甲状腺素蛋白淀粉样心肌病 (ATTR-CM) 患者的死亡率和心血管 (CV) 相关住院率。该分析旨在评估 ATTRACT 中与 CV 相关的死亡和住院原因，以进一步了解 ATTR-CM 的进展和 tafamidis 的疗效。 ATTR-ACT 是一项国际、双盲、安慰剂对照、随机研究。患有遗传性或野生型 ATTR-CM 的患者被随机分配接受 tafamidis (n = 264) 或安慰剂 (n = 177)，为期 30 个月。独立的终点裁决委员会使用预定义的标准确定某些研究者报告的事件是否符合疾病相关疗效终点的定义。评估了 CV 相关死亡（心力衰竭 [HF]、心律失常、心肌梗死、猝死、中风和其他 CV 原因）和住院（心力衰竭、心律失常、心肌梗死、短暂性脑缺血发作/中风和其他 CV 原因）的具体原因。与心血管相关的死亡总数，tafamidis 组为 53 例（20.1%），安慰剂组为 50 例（28.2%），心力衰竭（tafamidis 组 15.5%，安慰剂 22.6%），其次是猝死（tafamidis 组 2.7%，安慰剂 5.1%），这是最常见的原因。服用他法米迪的患者中因心血管相关住院的患者人数为 138 例（52.3%），服用安慰剂的患者为 107 例（60.5%）；心力衰竭是最常见的原因（43.2% 他法米迪，50.3% 安慰剂）。与安慰剂相比，tafamidis 组中所有预先确定的 CV 相关死亡或住院原因的发生率均较低。总之，这些数据提供了对 ATTR-CM 患者心血管疾病进展的进一步了解，其中心力衰竭是 ATTR-ACT 中 CV 相关住院或死亡的最常见原因。 (C) 2021 作者。由爱思唯尔公司出版
In the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT), tafamidis significantly reduced mortality and cardiovascular (CV)-related hospitalizations compared with placebo in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). This analysis aimed to assess the causes of CV-related death and hospitalization in ATTRACT to provide further insight into the progression of ATTR-CM and efficacy of tafamidis. ATTR-ACT was an international, double-blind, placebo-controlled, and randomized study. Patients with hereditary or wild-type ATTR-CM were randomized to tafamidis (n = 264) or placebo (n = 177) for 30 months. The independent Endpoint Adjudication Committee determined whether certain investigator-reported events met the definition of disease-related efficacy endpoints using predefined criteria. Cause-specific reasons for CV-related deaths (heart failure [HF], arrhythmia, myocardial infarction, sudden death, stroke, and other CV causes) and hospitalizations (HF, arrhythmia, myocardial infarction, transient ischemic attack/stroke, and other CV causes) were assessed. Total CV-related deaths was 53 (20.1%) with tafamidis and 50 (28.2%) with placebo, with HF (15.5% tafamidis, 22.6% placebo), followed by sudden death (2.7% tafamidis, 5.1% placebo), the most common causes. The number of patients with a CV-related hospitalization was 138 (52.3%) with tafamidis and 107 (60.5%) with placebo; with HF the most common cause (43.2% tafamidis, 50.3% placebo). All predefined causes of CV-related death or hospitalization were less frequent with tafamidis than placebo. In conclusion, these data provide further insight into CV disease progression in patients with ATTR-CM, with HF the most common adjudicated cause of CV-related hospitalization or death in ATTR-ACT. (C) 2021 The Authors. Published by Elsevier Inc.