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August 29, 2026Cardiology and TherapyOpen Access

Cardiovascular-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 Extension

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Authors

TDThibaud DamyRWRonald WittelesFCFrancesco Cappelli

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Overview

Randomized trial post hoc analysis demonstrates continuous tafamidis reduces cardiovascular events and mortality in transthyretin amyloid cardiomyopathy, indicating durable long-term benefit.

Key Points

  • To evaluate the long-term impact of continuous tafamidis compared with delayed tafamidis initiation on recurrent cardiovascular-related hospitalizations and cardiovascular mortality in patients with transthyretin amyloid cardiomyopathy.
  • Post hoc analysis of the randomized phase 3 ATTR-ACT trial (30 months) and its long-term extension (60 months; total follow-up up to 90 months; NCT01994889, NCT02791230).
  • Compared patients receiving continuous tafamidis 80 mg (n = 176) against those receiving placebo during ATTR-ACT who subsequently switched to tafamidis 80 mg in the extension (n = 177).
  • Time to recurrent cardiovascular-related events and cardiovascular-related mortality were assessed using Liu–Wei–Yang–Ying and Cox proportional hazards regression models, respectively.
  • Continuous tafamidis 80 mg significantly reduced cardiovascular-related events versus placebo/delayed switch at month 24 (48% vs 61%; HR 0.713, 95% CI 0.524–0.970, p = 0.0310) and month 90 (77% vs 79%; HR 0.629, 95% CI 0.491–0.806, p = 0.0002).
  • Cardiovascular mortality was significantly reduced with continuous tafamidis at month 24 (21% vs 29%; HR 0.618, 95% CI 0.401–0.954, p = 0.0299) and month 90 (39% vs 47%; HR 0.607, 95% CI 0.436–0.843, p = 0.0029).
  • Reductions in cardiovascular events and mortality were observed in patients with baseline NYHA functional class I/II, but not in those with baseline NYHA class III.

Cite This Study

Damy et al. (2026) studied this question.

synapsesocial.com/papers/6a92994d8e5d7d1fc0c112e7https://doi.org/10.1007/s40119-026-00470-8
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Also Consider

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

  1. 1Tafamidis treatment significantly reduces the risk of recurrent cardiovascular-related hospitalisation in patients with early stage transthyretin amyloid cardiomyopathy2025
  2. 2Annual Cardiovascular-Related Hospitalization Days Avoided with Tafamidis in Patients with Transthyretin Amyloid Cardiomyopathy2022 · 15 citations
  3. 3Survival in a contemporary, real-world, matched cohort of patients with transthyretin amyloid cardiomyopathy treated vs not treated with tafamidis2025 · 1 citations
  4. 4Impact of Tafamidis on Transthyretin Concentration and Its Relation to All-Cause Mortality in Patients with Transthyretin Amyloid Cardiomyopathy: An Analysis from ATTR-ACT2026
  5. 5Survival in a Contemporary, Real-World, Matched Cohort of Patients with Transthyretin Amyloid Cardiomyopathy Treated vs Not Treated with Tafamidis2026