{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T04:19:17Z","timestamp":1793420357793,"version":"4.5.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite the belief that heart failure therapies are not effective in transthyretin cardiac amyloidosis, data are limited. We tested the association of neurohormonal blockade use with survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">A total of 309 consecutive patients with transthyretin cardiac amyloidosis were identified. Medication inventory was obtained at baseline and subsequent visits. Exposure included a neurohormonal blockade class (\u03b2\u2010blocker [\u03b2B], angiotensin\u2010converting enzyme inhibitor\/angiotensin receptor blocker, and mineralocorticoid antagonist) at baseline and subsequent visits. \u03b2B was modeled as baseline use, time\u2010varying use, and in an inverse probability treatment weighted model. Primary outcome was all\u2010cause mortality analyzed with adjusted Cox proportional hazards models. Continuing compared with stopping \u03b2B during follow\u2010up was tested. Mean age was 73.2\u00a0years, 84.1% were men, and 17.2% had atrial fibrillation\/flutter at baseline. At the time of study entry, 49.8% were on \u03b2Bs, 35.0% were on angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers, and 23.9% were on mineralocorticoid antagonists. For the total cohort, there was a trend toward harm in the unadjusted model for baseline \u03b2B use, but this was neutral after adjustment. When \u03b2B use was analyzed as a time\u2010varying exposure, there was no association with mortality. \u03b2B discontinuation was associated with decreased mortality for the total cohort. Findings were consistent in inverse probability treatment weighted models. For angiotensin\u2010converting enzyme inhibitor\/angiotensin receptor blocker or mineralocorticoid antagonist use, there was no association with mortality after adjustment for the total cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">There was no association of neurohormonal blockade use with survival in transthyretin cardiac amyloidosis. For the total cohort, deprescribing \u03b2B may be associated with improved survival. Additional studies are needed to confirm these findings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.022859","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T09:05:15Z","timestamp":1635930315000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":63,"title":["Lack of Association Between Neurohormonal Blockade and Survival in Transthyretin Cardiac Amyloidosis"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5994-5998","authenticated-orcid":false,"given":"Richard K.","family":"Cheng","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-5364","authenticated-orcid":false,"given":"Alexi","family":"Vasbinder","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Nursing and Health Informatics University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne C.","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-3737","authenticated-orcid":false,"given":"Parag","family":"Goyal","sequence":"additional","affiliation":[{"name":"Division of Cardiology Division of General Internal Medicine Weill Cornell Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-7464","authenticated-orcid":false,"given":"Jan M.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Division of Cardiology Columbia University Irving Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8510-0796","authenticated-orcid":false,"given":"Douglas J.","family":"Leedy","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5400-5008","authenticated-orcid":false,"given":"Mathew S.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Columbia University Irving Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.04.003"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000792"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.078915"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.910455"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12153"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.03.023"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2020.06.007"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000509"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008670"},{"key":"e_1_3_1_11_2","unstructured":"FDA prescribing information for tafamidis . 2021. 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