{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:06:58Z","timestamp":1789592818080,"version":"build-2803163510"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The natural history and response to tafamidis treatment in women with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) remain insufficiently characterized. Current study aimed to explore sex-differences in clinical presentation, natural course, and tafamidis treatment efficacy, focusing on women with ATTRwt-CM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>An international, multicentric cohort of ATTRwt-CM subjects was evaluated, including for all-cause mortality. In total, 1454 patients were studied (mean age 81 \u00b1 7y), including 307 (21.1%) females. At presentation, females were \u223c3 years older than males with slightly worse phenotype, including higher indexed left ventricular wall thickness and National Amyloidosis Centre (NAC) disease stage (P &amp;lt; 0.050). Heart failure with preserved ejection fraction and hypertension coincided more often in women (P = 0.001). Natural disease course was poor without sex-difference, even when age-corrected (P = 0.210). Tafamidis was initiated in 1055 patients, 12% less in females (P &amp;lt; 0.001), although reasons for non-initiation and discontinuation did not show heterogeneity by sex (P = 0.116 and P = 0.304, respectively), indicating structural undertreatment. After 1.9 (0.9\u20133.3) years of median follow-up, 409 (28.1%) patients died. Tafamidis related to lower mortality in the overall and propensity score-matched cohort (n = 742, HR 0.44, 95% CI 0.32\u20130.61, P &amp;lt; 0.001), without sex-difference (female HR 0.76, 95% CI 0.52\u20131.11, P = 0.150) nor sex-based treatment efficacy interaction (P = 0.381). NAC disease stages strongly related to mortality under tafamidis treatment (HR 2.13%, 95%, 1.81\u20132.50, P &amp;lt; 0.001), but female sex did not (HR 0.82, 95% CI 0.53\u20131.27, P = 0.365).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Women with ATTRwt-CM are prone to underdiagnosis and undertreatment, despite similar poor natural course and tafamidis treatment efficacy. Initiatives to increase diagnostic awareness and disease modifying treatment initiation in women are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcag074","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T11:46:23Z","timestamp":1776858383000},"page":"965-976","source":"Crossref","is-referenced-by-count":3,"title":["Tafamidis in women with wild-type transthyretin cardiac amyloidosis: an international cohort study"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1196-3016","authenticated-orcid":false,"given":"Philippe","family":"Debonnaire","sequence":"first","affiliation":[{"name":"Cardiology Department, AZ Sint-Jan Brugge , Ruddershove 10, Bruges 8000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"L\u2019Hoyes","sequence":"additional","affiliation":[{"name":"Cardiology Department, AZ Sint-Jan Brugge , Ruddershove 10, Bruges 8000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Dujardin","sequence":"additional","affiliation":[{"name":"Cardiology Department, AZ Delta , Roeselare ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2677-3389","authenticated-orcid":false,"given":"Erwan","family":"Donal","sequence":"additional","affiliation":[{"name":"Cardiology Department, CHU Rennes , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7414-4056","authenticated-orcid":false,"given":"Nicolas","family":"Verheyen","sequence":"additional","affiliation":[{"name":"Cardiology Department, Medical University Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0802-9508","authenticated-orcid":false,"given":"Matthias","family":"Dupont","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ziekenhuis Oost-Limburg , Genk ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"De Sutter","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ziekenhuis Maria Middelares , Gent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Philippe","family":"Timmermans","sequence":"additional","affiliation":[{"name":"Cardiology Department, Jessa Ziekenhuis , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Catherine","family":"Pouleur","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cliniques Universitaires St.Luc , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3985-3249","authenticated-orcid":false,"given":"Steven","family":"Droogmans","sequence":"additional","affiliation":[{"name":"Centrum Voor Hart-en Vaatziekten, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Jette ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Sarli","family":"Issa","sequence":"additional","affiliation":[{"name":"Cardiology Department, Universitair Ziekenhuis Antwerpen , Edegem ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Dulgheru","sequence":"additional","affiliation":[{"name":"Cardiology Department, CHU Sart-Tilman , Li\u00e8ge ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelien","family":"Regeer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Centre , Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3438-2612","authenticated-orcid":false,"given":"Ruxandra","family":"Jurcut","sequence":"additional","affiliation":[{"name":"Expert Center for Genetic Cardiovascular Diseases, Emergency Institute for Cardiovascular Diseases \u2018Prof. dr. 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Iliescu\u2019, University of Medicine and Pharmacy \u2018Carol Davila\u2019 , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4575-5231","authenticated-orcid":false,"given":"Ren\u00e9","family":"Tavernier","sequence":"additional","affiliation":[{"name":"Cardiology Department, AZ Sint-Jan Brugge , Ruddershove 10, Bruges 8000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Buysschaert","sequence":"additional","affiliation":[{"name":"Cardiology Department, AZ Sint-Jan Brugge , Ruddershove 10, Bruges 8000 ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Trenson","sequence":"additional","affiliation":[{"name":"Cardiology Department, AZ Sint-Jan Brugge , Ruddershove 10, Bruges 8000 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