**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Ahmad Masri
Oregon Health & Science University
Portland, OR

**Main Body of the Abstract**
Background: Cardiovascular hospitalization (CVH) is an indicator of higher mortality in patients with undifferentiated heart failure. Whether this association might be observed in the ATTR-CM population is unknown.
Methods: The phase 3 ATTRibute-CM trial of acoramidis – a novel, potent, near-complete transthyretin (TTR) stabilizer that increases serum TTR (prealbumin) – demonstrated improved clinical outcomes in ATTR-CM patients including a 50% reduction in the risk of CVH compared to placebo over 30 months, with a positive treatment effect observed as early as 3 months. From this trial, the relationship between those with or without CVH and survival was analyzed across treatment arms using the Kaplan-Meier method statistical approach.
Results: In ATTRibute-CM, the mean (±SD) age of the patients was 77±6.6 years, 90.2% were men, and 90.3% had wild-type TTR. The baseline median (IQR) NT-proBNP was 2326 (1278-3910) pg/mL and mean (±SD) eGFR 61±18 mL/min/1.73 m2. Those without any CVH had a 30-month survival of 86.7% (95% CI = 82.9, 89.7) versus 60.1% (95% CI = 52.8, 66.7) in those who had any CVH (p<0.0001) as seen in the figure. Analysis is ongoing and additional results will be presented.
Conclusion: To our knowledge, this is the first time a prospective trial demonstrates that CVH portends a higher subsequent mortality in ATTR-CM patients. This suggests that effective treatment to reduce the need for CVH is critically important, and highly effective, targeted therapy for ATTR-CM that reduces CVH can improve the prognosis of patients with ATTR-CM.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Ahmad Masri
Oregon Health & Science University
Portland, OR

**Main Body of the Abstract**
**Background**: Cardiovascular hospitalization (CVH) is an indicator of higher mortality in patients with undifferentiated heart failure. Whether this association might be observed in the ATTR-CM population is unknown.
**Methods**: The phase 3 ATTRibute-CM trial of acoramidis – a novel, potent, near-complete transthyretin (TTR) stabilizer that increases serum TTR (prealbumin) – demonstrated improved clinical outcomes in ATTR-CM patients including a 50% reduction in the risk of CVH compared to placebo over 30 months, with a positive treatment effect observed as early as 3 months. From this trial, the relationship between those with or without CVH and survival was analyzed across treatment arms using the Kaplan-Meier method statistical approach.
**Results**: In ATTRibute-CM, the mean (±SD) age of the patients was 77±6.6 years, 90.2% were men, and 90.3% had wild-type TTR. The baseline median (IQR) NT-proBNP was 2326 (1278-3910) pg/mL and mean (±SD) eGFR 61±18 mL/min/1.73 m2. Those without any CVH had a 30-month survival of 86.7% (95% CI = 82.9, 89.7) versus 60.1% (95% CI = 52.8, 66.7) in those who had any CVH (p<0.0001) as seen in the figure. Analysis is ongoing and additional results will be presented.
**Conclusion:** To our knowledge, this is the first time a prospective trial demonstrates that CVH portends a higher subsequent mortality in ATTR-CM patients. This suggests that effective treatment to reduce the need for CVH is critically important, and highly effective, targeted therapy for ATTR-CM that reduces CVH can improve the prognosis of patients with ATTR-CM.



Higher Risk of Mortality in Previously Hospitalized Patients: Insights from ATTRibute-CM PC122 (#279)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.