{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:02:21Z","timestamp":1789970541271,"version":"4.0.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Amyloid transthyretin cardiomyopathy (ATTR-CM) is a progressive infiltrative cardiomyopathy that has seen significant advances in diagnosis and treatment over the last two decades. Sex differences in phenotype, treatment response, and long-term outcomes remain poorly understood. Our study aims to describe the factors that contribute to differences in phenotype and long-term outcomes between male and female patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single-center retrospective analysis of 334 patients with ATTR-CM seen at Northwestern Memorial Hospital, Chicago, IL, USA. The study included adults &amp;gt;18\u2005years with an ATTR-CM diagnosis (wild-type, variant). Immunoglobulin light chain (AL) amyloidosis patients were excluded. Patients were classified as male or female based on the biological gender described in the electronic medical record. Male patients with ATTR-CM were compared with female patients with ATTR-CM. The National Amyloidosis Centre (NAC) stage was calculated using clinical parameters at the time of diagnosis. The primary outcome was all-cause mortality. Baseline characteristics were compared using chi-squared analysis. Associations were determined using Kaplan\u2013Meier estimation and restricted mean survival time analysis (RMST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 334 patients with ATTR-CM\u2014268 (80%) men and 66 (20%) women. Female patients were diagnosed at higher NAC stages (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), had lower pre-albumin levels and a lower estimated glomerular filtration rate, higher N-terminal pro-B-type natriuretic peptide levels, a higher prevalence of the ATTR variant genotype, and were more likely to be African American. During a median follow-up of 42\u2005months (IQR 17\u201370), 74 deaths occurred. The unadjusted 60-month RMST difference between men and women was \u22122.2\u2005months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.37). In our multivariable analysis, age at diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and atrial fibrillation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) were the only factors associated with increased mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Female patients present with ATTR-CM at significantly later NAC stages than men. Despite this, they have a similar mortality rate. Our findings may demonstrate that the NAC stage overestimates disease severity in female patients or, alternatively, that biological mechanisms confer a less aggressive disease phenotype in female patients despite advanced disease staging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1900402","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:36:14Z","timestamp":1789968974000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex differences in amyloid transthyretin cardiomyopathy National Amyloidosis Centre staging at diagnosis: an analysis from a large single-center cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"C.","family":"Mutebi","sequence":"first","affiliation":[{"name":"Department of Medicine, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Kusi","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. C.","family":"Ositelu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Oputa","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Rasberry","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Cremer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Youmans","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lehrer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tibrewala","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. L.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. S.","family":"Okwuosa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine, Northwestern University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"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":"B2","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.cardfail.2025.07.007","article-title":"HF STATS 2025: heart failure epidemiology and outcomes statistics\u2014an updated 2025 report from the Heart Failure Society of America","volume":"32","author":"Fonarow","year":"2026","journal-title":"J Card 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