{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:37:25Z","timestamp":1790105845242,"version":"4.0.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"am","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BridgeBio Pharma Inc."},{"DOI":"10.13039\/100004326","name":"Bayer AG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acoramidis, an oral transthyretin stabilizer that achieves near-complete (\u226590%) transthyretin stabilization, demonstrated significant clinical benefit over placebo in participants with transthyretin amyloid cardiomyopathy (ATTR-CM) in the phase 3 ATTRibute-CM trial (NCT03860935).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Post-hoc exploratory analyses of ATTRibute-CM were performed to evaluate associations between outpatient worsening heart failure (HF) (initiation\/escalation of oral loop diuretics) and clinical outcomes, the impact of acoramidis on outpatient worsening HF, and the effect of acoramidis on clinical outcomes adjusting for time-dependent first outpatient worsening HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the modified-intention-to-treat population, 287\/611 participants (46.97%) experienced outpatient worsening HF, which was associated with an increased risk of all-cause mortality (ACM)\/recurrent cardiovascular hospitalization (CVH) (hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.51\u20132.51), first CVH (HR 2.78, 95% CI 1.95\u20133.95), ACM (HR 1.64, 95% CI 1.14\u20132.36), and cardiovascular mortality (HR 1.63, 95% CI 1.08\u20132.46) through month 30. Acoramidis was associated with a 41% risk reduction of first outpatient worsening HF versus placebo (HR 0.59, 95% CI 0.46\u20130.75); Kaplan\u2013Meier curves separated early, nominal statistical significance was first reached at day 30 (HR 0.562, 95% CI 0.317\u20130.998; P = .0492), and sustained nominal statistical significance was achieved at day 134 through month 30. When adjusting for time-dependent first outpatient worsening HF over 30 months, acoramidis reduced the risk of ACM\/recurrent CVH and first CVH versus placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Outpatient worsening HF was associated with clinical outcomes in ATTR-CM. Acoramidis reduced the risk of outpatient worsening HF; effects emerged early and persisted throughout follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag177","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:48:16Z","timestamp":1779968896000},"source":"Crossref","is-referenced-by-count":2,"title":["Outpatient worsening heart failure in transthyretin amyloid cardiomyopathy: findings from ATTRibute-CM"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9233-9831","authenticated-orcid":false,"given":"Marianna","family":"Fontana","sequence":"first","affiliation":[{"name":"National Amyloidosis Centre, University College London, Royal Free Hospital , Rowland Hill Street, London NW3 2PF ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cappelli","sequence":"additional","affiliation":[{"name":"Tuscan Referral Center for Amyloid Treatment, Department of Clinical and Experimental Medicine, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Garcia-Pavia","sequence":"additional","affiliation":[{"name":"Department of Cardiology of Hospital Universitario Puerta de Hierro Majadahonda, IDIPHIM, CIBERCV , Madrid ,","place":["Spain"]},{"name":"Centro Nacional de Investigaciones Cardiovasculares (CNIC) Divison of Inherited Cardiomyopathies, , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P","family":"Judge","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina Division of Cardiology, , Charleston, SC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-700X","authenticated-orcid":false,"given":"Laura","family":"Obici","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Centre, IRCCS Fondazione Policlinico San Matteo , Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6390-6526","authenticated-orcid":false,"given":"Ahmad","family":"Masri","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University Division of Cardiovascular Medicine, , Portland, OR ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o R","family":"Agostinho","sequence":"additional","affiliation":[{"name":"Cardiology Department, Santa Maria University Center , Lisbon ,","place":["Portugal"]},{"name":"CAML, CCUL@RISE , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-8985","authenticated-orcid":false,"given":"Carsten","family":"Tsch\u00f6pe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Medicine at Campus Virchow (CVK), Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin ,","place":["Germany"]},{"name":"Berlin Institute of Health (BIH) at Charit\u00e9\u2014Center for Regenerative Therapies (BCRT) Department of Cardiology, , Berlin ,","place":["Germany"]},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Charit\u00e9 University , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Vogtl\u00e4nder","sequence":"additional","affiliation":[{"name":"Medical Affairs Statistics, Bayer AG , Wuppertal ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ciaccia","sequence":"additional","affiliation":[{"name":"Bayer Inc , Mississauga, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Zazula","sequence":"additional","affiliation":[{"name":"Bayer S.A. , Sao Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zeitler","sequence":"additional","affiliation":[{"name":"Bayer AG , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Tamby","sequence":"additional","affiliation":[{"name":"BridgeBio Pharma, Inc. , SanFrancisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C","family":"Fox","sequence":"additional","affiliation":[{"name":"BridgeBio Pharma, Inc. , SanFrancisco, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6174-9232","authenticated-orcid":false,"given":"Julian D","family":"Gillmore","sequence":"additional","affiliation":[{"name":"National Amyloidosis Centre, University College London, Royal Free Hospital , Rowland Hill Street, London NW3 2PF ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4058-3848","authenticated-orcid":false,"given":"Thibaud","family":"Damy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Referral Center for Cardiac Amyloidosis, H\u00f4pital Henri-Mondor , Cr\u00e9teil ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"2026060918211178100_xuag177-B1","doi-asserted-by":"publisher","first-page":"2872","DOI":"10.1016\/j.jacc.2019.04.003","article-title":"Transthyretin amyloid cardiomyopathy: JACC state-of-the-art review","volume":"73","author":"Ruberg","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026060918211178100_xuag177-B2","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1093\/eurheartj\/ehae811","article-title":"Transthyretin amyloid cardiomyopathy: a paradigm for advancing 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