What question did this study set out to answer?

To analyze the impact of acoramidis on serum TTR levels and its association with patient outcomes in ATTR-CM.

April 4, 2026Open Access

ATTR-CM: What do we know about blood levels of the TTR protein? A discussion with experts

MMMathew S. MaurerGeneral Cardiology ACAdam Castaño

Key Points

To analyze the impact of acoramidis on serum TTR levels and its association with patient outcomes in ATTR-CM.
Analysis based on the ATTRibute-CM clinical trial
Evaluation of 557 patients' serum TTR levels
Monitoring changes at baseline, 28 days, and month 30
Assessment of mortality odds related to sTTR changes
Acoramidis significantly increased serum TTR levels by a mean of 9.1 mg/dL by day 28.
Incremental sTTR increases of +5 mg/dL were linked to a 31.6% reduction in mortality odds through month 30.
Early and sustained rises in sTTR levels correlate with improved survival outcomes.

Abstract

Transthyretin (TTR) amyloid cardiomyopathy occurs when stable TTR, normally a 4-protein tetramer, becomes misfolded and aggregates to form amyloid fibrils that accumulate in the heart. Progressive accumulation causes cardiomyopathy, leading to arrhythmia and heart failure. Acoramidis is a high-affinity TTR stabilizer (⩾90%) evaluated in the ATTRibute-CM clinical trial. In this podcast discussion, Dr Mathew Maurer and Dr Adam Castaño provide insights into their recent analysis of prognostic implications of acoramidis-mediated changes to serum TTR (sTTR) in 557 patients and the associated implications for all-cause mortality. For the patients included in this analysis, acoramidis fully mediated a sharp and significant early rise in sTTR levels (mean 9.1 mg/dL) by day 28, sustained through month 30. Incremental changes (+5 mg/dL) in sTTR were associated with a 31.6% lower odds of mortality through month 30. This evidence strongly supports a direct association between early, sustained sTTR increases with acoramidis treatment and survival.

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