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March 30, 2022American Journal of Cardiovascular DrugsOpen Access

Annual Cardiovascular-Related Hospitalization Days Avoided with Tafamidis in Patients with Transthyretin Amyloid Cardiomyopathy

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Key result

Tafamidis significantly reduced the annual rate of cardiovascular-related hospitalizations by 32.4% (RR 0.68) and shortened the mean length of stay compared to placebo in patients with transthyretin amyloid cardiomyopathy.

Why the study?

Because length of stay affects total hospitalization burden, this study evaluated the impact of tafamidis on the number of cardiovascular-related hospital days avoided in patients with ATTR-CM.

Does tafamidis reduce the total number of cardiovascular-related hospitalization days in patients with transthyretin amyloid cardiomyopathy?

Population

Patients with ATTR-CM from ATTR-ACT

Comparison

Tafamidis vs placebo

Design

Post hoc analysis of a clinical trial

Authors

MRMark H. RozenbaumDTDiana TranRBRahul Bhambri

Discussion

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Overview

Tafamidis-associated shorter stays may ease ATTR-CM hospitalization burden; leaves open real-world confirmation beyond trial data.

Key Points

  • To evaluate the impact of tafamidis on the total number of cardiovascular-related hospital days avoided in patients with transthyretin amyloid cardiomyopathy.
  • A post hoc analysis was conducted using data from the randomized, multicenter Transthyretin Amyloidosis Cardiomyopathy Clinical Trial (ATTR-ACT; NCT01994889).
  • Total burden of cardiovascular-related hospitalizations, including annual event rates and mean length of stay per event, was calculated and compared between tafamidis and placebo arms.
  • In the overall population, tafamidis significantly reduced annual cardiovascular hospitalizations compared to placebo (0.4750 vs. 0.7025 events/year; relative risk reduction [RRR] 0.68; p < 0.0001) and shortened mean stay per event (8.6250 vs. 9.5625 days), preventing 2.62 hospital days per patient per year.
  • In patients with early-stage disease (NYHA class I/II), tafamidis reduced annual cardiovascular hospitalizations by 52% (0.3378 vs. 0.7091; RRR 0.48; p < 0.0001) and reduced annual hospital days by 3.96 days per patient.

Study Design

Type

RCT (n=441)

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does tafamidis reduce the total number of cardiovascular-related hospitalization days in patients with transthyretin amyloid cardiomyopathy?

P
Population
441 patients with transthyretin amyloid cardiomyopathy and evidence of cardiac involvement, excluding NYHA class IV, followed for 30 months.
I
Intervention
Tafamidis (pooled doses of 80 or 20 mg) over 30 months
C
Comparator
Placebo
O
Outcome
Total burden of cardiovascular-related hospitalization (days) per yearhard clinical

Main Result

Relative Risk: 0.68

Absolute Event Rate: 0.475% vs 0.7025%

p-value: p=<0.0001

Tafamidis significantly reduces the frequency and length of cardiovascular-related hospitalizations in patients with ATTR-CM, particularly when initiated early in the disease course.

Limitations

  • Could not adjust for global variability in disease management in the data from ATTR-ACT for hospitalizations
  • Confounding effect of death on CV-related hospitalizations that underestimates the hospitalization effect of tafamidis
  • Very low number of patients with baseline NYHA class I enrolled in ATTR-ACT
  • Could not adjust for global variability in disease management
  • Average estimate using hospitalization data from all treated patients rather than only hospitalized patients
  • Confounding survivor bias in NYHA class III patients underestimates the hospitalization effect

Cite This Study

Rozenbaum et al. (2022) conducted an RCT in Transthyretin Amyloid Cardiomyopathy (n=441). Tafamidis vs. Placebo was evaluated on Mean annual frequency of cardiovascular-related hospitalizations (RRR 0.68, p=<0.0001). Tafamidis significantly reduced the annual rate of cardiovascular-related hospitalizations by 32.4% (RR 0.68) and shortened the mean length of stay compared to placebo in patients with transthyretin amyloid cardiomyopathy.

synapsesocial.com/papers/6a6f4e9778a11c550e08ff6dhttps://doi.org/10.1007/s40256-022-00526-9
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiovascular-Related Mortality and Hospitalizations in Patients with Transthyretin Amyloid Cardiomyopathy Treated with Tafamidis: A Post Hoc Analysis of the Phase 3 ATTR-ACT and Long-Term Extension2026
  2. 2Tafamidis treatment significantly reduces the risk of recurrent cardiovascular-related hospitalisation in patients with early stage transthyretin amyloid cardiomyopathy2025
  3. 3Reduction of heart failure hospitalization-related healthcare costs for transthyretin amyloid cardiomyopathy patients on treatment2025
  4. 4Tafamidis: A game changer in transthyretin cardiomyopathy? A systematic review and meta-analysis of safety and efficacy2025
  5. 5Tafamidis Reduces Death and Hospitalization for Acute Heart Failure in Octogenarian Patients With Transthyretin Cardiac Amyloidosis: A Propensity Score–Weighted Cohort Study2025