{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T09:02:15Z","timestamp":1794301335892,"version":"4.9.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008021","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008021","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Takeda Pharmaceuticals"},{"DOI":"10.13039\/100019718","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019718","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012112","name":"Swedish Orphan Biovitrum AB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012112","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>In real-world, wild-type transthyretin cardiomyopathy is increasingly diagnosed in patients \u2265 80 years old (octogenarians), although being underrepresented in randomized clinical trials. Specific data on natural course and outcome under tafamidis treatment in octogenarians are therefore scarce. The impact of tafamidis treatment on mortality in real-world wild-type transthyretin cardiomyopathy octogenarians was studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An international, multicentre cohort study of 710 consecutive wild-type transthyretin cardiomyopathy patients with mean follow-up of 2.2 \u00b1 1.8 years for all-cause mortality endpoint was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort consisted of 58.5% (415\/710) octogenarians (85 \u00b1 4 years, 74.2% male). Before tafamidis availability, natural course in octogenarians (148\/257) vs. non-octogenarians (109\/257) was poor, with 16% 1-year and 71% 5-year mortality vs. 8% and 47%, respectively (P &amp;lt; .001). Since tafamidis availability, 70.1% (253\/361) octogenarians were initiated on tafamidis vs. 83.7% (231\/276) non-octogenarians (P &amp;lt; .001). Tafamidis discontinuation was similar (octogenarians 10.3% and non-octogenarians 7.4%; P = .260). Overall tafamidis treated vs. untreated octogenarians had better unadjusted survival (P &amp;lt; .001), with 5% 1-year and 24% 3-year mortality. Tafamidis treatment associated with lower mortality after propensity score matching on baseline variables, including age, National Amyloidosis Centre stage, and New York Heart Association class in on average 394 subjects [hazard ratio (HR) = 0.53, 95% confidence interval (CI) 0.34\u20130.84, P = .007], also in octogenarians (HR = 0.57, 95% CI 0.33\u20131.01, P = .053). Neither age at diagnosis (P = .217) nor at treatment initiation (P = .154) interacted with tafamidis mortality benefit. Octogenarians had poorer survival despite tafamidis, when initiated at \u226590 years (HR = 3.3, 95% CI 1.10\u20139.53, P = .033) and National Amyloidosis Centre Stage \u22653 (HR = 2.4, 95% CI 0.87\u20136.46, P = .090).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Real-world tafamidis treatment improves survival without age affecting treatment efficacy, although mortality remains considerable in octogenarians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehae923","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T15:30:25Z","timestamp":1734449425000},"page":"1057-1070","source":"Crossref","is-referenced-by-count":38,"title":["Tafamidis in octogenarians with wild-type transthyretin cardiac amyloidosis: an international cohort study"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1196-3016","authenticated-orcid":false,"given":"Philippe","family":"Debonnaire","sequence":"first","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Dujardin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Delta , Roeselare ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7414-4056","authenticated-orcid":false,"given":"Nicolas","family":"Verheyen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Catherine","family":"Pouleur","sequence":"additional","affiliation":[{"name":"Department of Cardiology, 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3998-5340","authenticated-orcid":false,"given":"Mathias","family":"Claeys","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9776-7467","authenticated-orcid":false,"given":"Alexandre","family":"Bohyn","sequence":"additional","affiliation":[{"name":"Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Interuniversity Centre for Biostatistics and Statistical Bioinformatics, UHasselt , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Bogaerts","sequence":"additional","affiliation":[{"name":"Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Interuniversity Centre for Biostatistics and Statistical Bioinformatics, UHasselt , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9436-7820","authenticated-orcid":false,"given":"Milad","family":"El Haddad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Christiaen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Wyseure","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Delta , Roeselare ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K","family":"Zach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Buytaert","sequence":"additional","affiliation":[{"name":"Centrum voor Hart- en Vaatziekten, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Jette ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemie","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Buysschaert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Trenson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raf","family":"Van Hoeyweghen","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, AZ Sint-Jan Brugge , Bruges ,","place":["Belgium"]}],"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":"Department of Cardiology, AZ Sint-Jan Brugge , Ruddershove 10, 8000 Bruges ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2025031314401843400_ehae923-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":"2025031314401843400_ehae923-B2","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/j.jacc.2016.06.033","article-title":"Natural history of wild-type transthyretin cardiac amyloidosis and risk stratification using a novel staging system","volume":"68","author":"Grogan","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2025031314401843400_ehae923-B3","doi-asserted-by":"publisher","first-page":"863179","DOI":"10.3389\/fcvm.2022.863179","article-title":"Assessment and management of older patients with transthyretin amyloidosis cardiomyopathy: geriatric cardiology, frailty assessment and beyond","volume":"9","author":"Irabor","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2025031314401843400_ehae923-B4","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/S0002-9149(98)00385-3","article-title":"Comparison of cardiac findings at necropsy in octogenarians, nonagenarians, and centenarians","volume":"82","author":"Roberts","year":"1998","journal-title":"Am J Cardiol"},{"key":"2025031314401843400_ehae923-B5","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1080\/07853890701842988","article-title":"Senile systemic amyloidosis affects 25% of the very aged and associates with genetic variation in alpha2-macroglobulin and tau: a population-based autopsy study","volume":"40","author":"Tanskanen","year":"2008","journal-title":"Ann Med"},{"key":"2025031314401843400_ehae923-B6","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1056\/NEJM199511023331824","article-title":"Survival after the age of 80 in the United States, Sweden, France, England, and Japan","volume":"333","author":"Manton","year":"1995","journal-title":"N Engl J Med"},{"key":"2025031314401843400_ehae923-B7","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1016\/S0140-6736(09)61460-4","article-title":"Ageing populations: the challenges ahead","volume":"374","author":"Christensen","year":"2009","journal-title":"Lancet"},{"key":"2025031314401843400_ehae923-B8","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1056\/NEJMoa1805689","article-title":"Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy","volume":"379","author":"Maurer","year":"2018","journal-title":"N Engl J Med"},{"key":"2025031314401843400_ehae923-B9","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.jchf.2023.08.032","article-title":"Tafamidis efficacy among octogenarian patients in the phase 3 ATTR-ACT and ongoing long-term extension study","volume":"12","author":"Garcia-Pavia","year":"2024","journal-title":"JACC Heart Fail"},{"key":"2025031314401843400_ehae923-B10","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1093\/eurheartj\/ehab072","article-title":"Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC working group on myocardial and pericardial diseases","volume":"42","author":"Garcia-Pavia","year":"2021","journal-title":"Eur Heart J"},{"key":"2025031314401843400_ehae923-B11","doi-asserted-by":"publisher","first-page":"2799","DOI":"10.1093\/eurheartj\/ehx589","article-title":"A new staging system for cardiac transthyretin amyloidosis","volume":"39","author":"Gillmore","year":"2018","journal-title":"Eur Heart J"},{"key":"2025031314401843400_ehae923-B12","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025031314401843400_ehae923-B13","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025031314401843400_ehae923-B14","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1093\/ehjci\/jew335","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"18","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025031314401843400_ehae923-B15","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1097\/EDE.0b013e3181a39056","article-title":"Prognostic models with competing risks: methods and application to coronary risk prediction","volume":"20","author":"Wolbers","year":"2009","journal-title":"Epidemiology"},{"key":"2025031314401843400_ehae923-B16","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1016\/j.jacc.2019.06.053","article-title":"Cardiovascular aging and heart failure: JACC review topic of the week","volume":"74","author":"Triposkiadis","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2025031314401843400_ehae923-B17","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.jchf.2013.11.004","article-title":"Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction","volume":"2","author":"Mohammed","year":"2014","journal-title":"JACC Heart Fail"},{"key":"2025031314401843400_ehae923-B18","doi-asserted-by":"publisher","first-page":"3875","DOI":"10.1002\/ehf2.13541","article-title":"Natural history and progression of transthyretin amyloid cardiomyopathy: insights from ATTR-ACT","volume":"8","author":"Nativi-Nicolau","year":"2021","journal-title":"ESC Heart Fail"},{"key":"2025031314401843400_ehae923-B19","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1056\/NEJMoa2305434","article-title":"Efficacy and safety of acoramidis in transthyretin amyloid cardiomyopathy","volume":"390","author":"Gillmore","year":"2024","journal-title":"N Engl J Med"},{"key":"2025031314401843400_ehae923-B20","doi-asserted-by":"publisher","first-page":"101086","DOI":"10.1016\/j.jacadv.2024.101086","article-title":"Age- and sex-related differences in patients with wild-type transthyretin amyloidosis: insights from THAOS","volume":"3","author":"Mora-Ayestaran","year":"2024","journal-title":"JACC Adv"},{"key":"2025031314401843400_ehae923-B21","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1161\/CIRCULATIONAHA.115.018852","article-title":"Heart failure resulting from age-related cardiac amyloid disease associated with wild-type transthyretin: a prospective, observational cohort study","volume":"133","author":"Connors","year":"2016","journal-title":"Circulation"},{"key":"2025031314401843400_ehae923-B22","doi-asserted-by":"publisher","first-page":"e003815","DOI":"10.1161\/CIRCHEARTFAILURE.116.003815","article-title":"Design and rationale of the Phase 3 ATTR-ACT clinical trial (tafamidis in transthyretin cardiomyopathy clinical trial)","volume":"10","author":"Maurer","year":"2017","journal-title":"Circ Heart Fail"},{"key":"2025031314401843400_ehae923-B23","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/jgs.13838","article-title":"Survival prognosis in very old adults","volume":"64","author":"Thinggaard","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"2025031314401843400_ehae923-B24","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1161\/CIRCULATIONAHA.119.045093","article-title":"Cost-effectiveness of tafamidis therapy for transthyretin amyloid cardiomyopathy","volume":"141","author":"Kazi","year":"2020","journal-title":"Circulation"},{"key":"2025031314401843400_ehae923-B25","doi-asserted-by":"publisher","first-page":"e008105","DOI":"10.1161\/CIRCHEARTFAILURE.120.008105","article-title":"Prevalence and prognostic significance of frailty among patients with transthyretin amyloidosis cardiomyopathy","volume":"14","author":"Fine","year":"2021","journal-title":"Circ Heart Fail"}],"container-title":["European Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/46\/11\/1057\/62175030\/ehae923.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/46\/11\/1057\/62175030\/ehae923.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T10:42:16Z","timestamp":1741862536000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartj\/article\/46\/11\/1057\/8042893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,2,26]]},"published-print":{"date-parts":[[2025,3,13]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/ehae923","relation":{},"ISSN":["0195-668X","1522-9645"],"issn-type":[{"value":"0195-668X","type":"print"},{"value":"1522-9645","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,3,14]]},"published":{"date-parts":[[2025,2,26]]}}}