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Multicenter Study
. 2025 Oct 15:437:133522.
doi: 10.1016/j.ijcard.2025.133522. Epub 2025 Jun 16.

Impact of Tafamidis on survival in elderly patients: Insights from the Healthcare European Amyloidosis Registry

Antoine Jobbé-Duval  1 , Mounira Kharoubi  2 , Erwan Donal  3 , Fabrice Bauer  4 , Amaury Broussier  5 , Arnaud Bisson  6 , Océane Bouchot  7 , Phillipe Charron  8 , Jérôme Costa  9 , Pierre-Yves Courand  10 , Charlotte Dagrenat  11 , François Delelis  12 , Jean-Christophe Eicher  13 , Antoine Fraix  14 , Barnabas Gellen  15 , Jean-Pierre Gueffet  16 , Gilbert Habib  17 , Jocelyn Inamo  18 , Julien Jeanneteau  19 , Damien Legallois  20 , Léa Margerit  21 , Basile Mouhat  22 , Nicolas Piriou  23 , Tania Puscas  24 , Patricia Réant  25 , François Roubille  26 , Romain Trésorier  27 , Jean-Jacques Von Hunolestein  28 , Charles Taieb  29 , Amira Zaroui  2 , Olivier Lairez  30 , Thibaud Damy  2
Affiliations
Free article
Multicenter Study

Impact of Tafamidis on survival in elderly patients: Insights from the Healthcare European Amyloidosis Registry

Antoine Jobbé-Duval et al. Int J Cardiol. .
Free article

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.

Keywords: ATTR-CM; Cardiac transthyretin amyloidosis; Elderly; Survival; Tafamidis.

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Conflict of interest statement

Declaration of competing interest Antoine Jobbe-Duval reports speaking/consulting fees from Alnylam Pharmaceuticals, Amicus Therapeutics, AstraZeneca, BMS, Pfizer, Bayer, and Sanofi-Genzyme. Arnaud Bisson received consultancy fees from BMS and Pfizer. Océane Bouchot reports honoraria from Biotronik. Amaury Broussier has received consultancy fees from Pfizer, Novartis, Vifor Pharma, Boehringer, and Astra Zeneca. Philippe Charron has received personal consultancy fees, outside the present work, for Amicus, Bristol Myers Squibb, Owkins, Pfizer, Sanofi and Servier. Jérôme Costa has received speaker fees from Edimark, Pfizer, Boehringer, Novartis, Servier, Amgen, BMS, Viatris, Alnylam, funding from Pfizer, and was part of an advisory board for Alnylam, Pfizer, Novartis Grand Est, Novonordisk, and Sanofi Genzyme. Pierre-Yves Courand reports honoraria/consulting fees from Abbvie, Amgen, Astellas, Astra-zeneca, Boehringer Ingelheim/Lilly, Bristol Myers Squibb, Medtronic, Organon, and Pfizer. Charlotte Dagrenat received consultancy fees from Pfizer and Alnylam. Antoine Fraix reports honoraria/consulting fees from Pfizer and Amgen. Julien Jeanneteau received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from BMS, Astrazeneca, Pfizer, and Novo Nordisk, and support for attending meetings and/or travel from Novartis, Medtronic, Boston, Abbott, and Biotronik. Olivier Lairez reports speaking/consulting fees from Alnylam Pharmaceuticals, Amicus Therapeutics, AstraZeneca, BMS, Bridgebio, Cytokinetics, Pfizer, Sanofi-Genzyme, and Siemens Healthiners. Damien Legallois reports honoraria/consulting fees from Astra Zeneca, Boehringer Ingelheim, Lilly, Pfizer and Takeda. Nicolas Piriou received consultancy fees from Pfizer, Alnylam, and Bayer. Patricia Réant received consultancy fees from Pfizer and Alnylam. François Roubille reports honoraria/fees from Astra Zeneca, Servier, Boehringer, Astra Zeneca, Vifor, Bayer, Pfizer, Novartis, Servier, Novonordisk, Air liquid, Abbott, QuidelOrtho, Newcard, MSD, BMS, Sanofi, Alnylam, Zoll, Implicity, GSK, and BMS. The remaining authors have nothing to disclose.

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Supplementary concepts