Conference Coverage

Higher CV Hospitalization Burden Associated With Mortality in ATTR-CM in New Post Hoc Analysis

Edited by:
Jennifer J. Spector, DPM, FACFAS

Key Highlights

  • Thirty-month survival was 86.7% among participants with no cardiovascular-related hospitalization events, 68.4% among those with one, and 47.7% among those with two or more.
  • The analysis pooled the acoramidis and placebo groups to examine the association between hospitalization burden and all-cause mortality.
  • Hospitalization timing was not accounted for in the analysis.

A greater burden of cardiovascular-related hospitalizations (CVH) was associated with lower survival over 30 months among participants with transthyretin amyloid cardiomyopathy (ATTR-CM) in a post hoc analysis of the phase 3 ATTRibute-CM trial. Researchers presented these findings as part of a poster at the Heart Failure Society of America 2026 Annual Scientific Meeting in Phoenix, AZ.

In ATTRibute-CM, participants were randomized 2:1 to receive acoramidis HCl 800 mg or placebo twice daily for 30 months. For this analysis, researchers pooled both treatment groups in the modified intention-to-treat population, which included randomized participants with a baseline estimated glomerular filtration rate of at least 30 mL/min/1.73 m². They compared subsequent all-cause mortality among participants who experienced no CVH events, one event, or two or more events during the study.

The researchers defined CVH as either a nonelective cardiovascular admission lasting at least 24 hours or an urgent outpatient visit for worsening heart failure that required intravenous diuretics. They used Kaplan-Meier curves to estimate survival and a log-rank test to compare the groups. The analysis did not adjust for when CVH events occurred.

Study Findings

Of 611 participants, 416 had no CVH events, 117 had one, and 78 had two or more. The proportion with variant ATTR-CM rose across those groups, from 7.5% to 12.0% to 17.9%. Median baseline NT-proBNP levels were 2046.0, 2473.0, and 2881.0 pg/mL, respectively.

Estimated 30-month survival was 86.7% (95% CI, 82.9%-89.7%) in the group with no CVH events, 68.4% (95% CI, 59.1%-76.0%) in the group with one event, and 47.7% (95% CI, 35.9%-58.6%) in the group with two or more events. Survival differed across groups by log-rank testing (P<.0001). These findings describe an association across pooled treatment groups; the analysis did not test whether preventing a hospitalization improved survival.

Clinical Implications

According to the authors, the association between CVH burden and subsequent mortality in ATTR-CM warrants further study of whether reductions in CVH with effective therapies are associated with improved survival.

Reference

Bui QM, Soman P, Emdin M, et al. Association between the burden of cardiovascular-related hospitalizations and all-cause mortality in transthyretin amyloid cardiomyopathy: insights from ATTRibute-CM. Presented at Heart Failure Society of America Annual Scientific Meeting. HFSA ePoster Library. October 10, 2026. Poster 4234703.