**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.**
Foteini Theodorakakou, Department of Clinical Therapeutics, National and Kapodistrian University of Athens Medical School, Athens, Greece

**Main Body of the Abstract**
Background: Delays in diagnosis in ATTR-CM may be region-specific and different outcomes have been reported.
Aim:To provide data about patients with ATTR-CM in Greece, evolving patterns and secular trends in their clinical and demographic characteristics.
Methods: This is a single-center observational study including all patients with ATTR-CM presenting in the Department of Clinical Therapeutics, from 01/2014 to 12/2023.  Genetic testing was performed in all cases.
Results: One-hundred and forty-two ATTR-CM patients were included (85% males, median age 82, 15% females, median age 85); 16 (11%) carried TTR mutations (25% had Val30Met). Numbers of diagnoses increased significantly after 2017. The majority (84%) presented with heart failure and 55% with atrial fibrillation, 9% had aortic stenosis, 87% had extracardiac manifestations (48% musculoskeletal disorders, 36% symptoms suggestive of peripheral neuropathy and 31% gastrointestinal symptoms). Those diagnosed after 2018 had lower NTproBNP, lower National amyloidosis Center (NAC) stage, and a higher male:female ratio. Eighty (56%) patients started tafamidis treatment, 12 (8.5%) with other stabilizers and 6 (4%) inotersen. Median follow-up is 31 months; 3-year survival is 58%. Advanced NYHA class and NAC stage-3 were associated with poorer survival (log-rank p<0.05) – there was no difference between NAC stage-1 & stage-2. Age, eGFR<45 ml/kg/m2, NTproBNP>5000 pg/mL (in all log-rank p<0.02) were associated with worse survival, in both whole cohort and tafamidis-treated subgroup.
Discussion: Our analysis shows a shift to diagnosis at a less advanced stage; however, more efforts are needed to facilitate early diagnosis.  National registries are important to understand diagnostic and treatment gaps.



**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.**
Foteini Theodorakakou, Department of Clinical Therapeutics, National and Kapodistrian University of Athens Medical School, Athens, Greece

**Main Body of the Abstract**
**Background:** Delays in diagnosis in ATTR-CM may be region-specific and different outcomes have been reported.
**Aim:**To provide data about patients with ATTR-CM in Greece, evolving patterns and secular trends in their clinical and demographic characteristics.
**Methods:** This is a single-center observational study including all patients with ATTR-CM presenting in the Department of Clinical Therapeutics, from 01/2014 to 12/2023.  Genetic testing was performed in all cases.
**Results:** One-hundred and forty-two ATTR-CM patients were included (85% males, median age 82, 15% females, median age 85); 16 (11%) carried _TTR_ mutations (25% had Val30Met). Numbers of diagnoses increased significantly after 2017. The majority (84%) presented with heart failure and 55% with atrial fibrillation, 9% had aortic stenosis, 87% had extracardiac manifestations (48% musculoskeletal disorders, 36% symptoms suggestive of peripheral neuropathy and 31% gastrointestinal symptoms). Those diagnosed after 2018 had lower NTproBNP, lower National amyloidosis Center (NAC) stage, and a higher male:female ratio. Eighty (56%) patients started tafamidis treatment, 12 (8.5%) with other stabilizers and 6 (4%) inotersen. Median follow-up is 31 months; 3-year survival is 58%. Advanced NYHA class and NAC stage-3 were associated with poorer survival (log-rank p<0.05) – there was no difference between NAC stage-1 & stage-2. Age, eGFR<45 ml/kg/m2, NTproBNP>5000 pg/mL (in all log-rank p<0.02) were associated with worse survival, in both whole cohort and tafamidis-treated subgroup.
**Discussion:** Our analysis shows a shift to diagnosis at a less advanced stage; however, more efforts are needed to facilitate early diagnosis.  National registries are important to understand diagnostic and treatment gaps.



Transthyretin amyloidosis in Greece:  Outcomes and changing diagnostic patterns PC64 (#353)

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.