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Cell-based Therapy for Heart Failure in Rat: Double Thoracotomy for Myocardial Infarction and Epicardial Implantation of Cells and Biomatrix
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Therapy of ATTR Cardiac Amyloidosis: Current Indications

Daniela Di Lisi1, Vincenzo Di Stefano2, Filippo Brighina2

  • 1Division of Cardiology, University Hospital Paolo Giaccone, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Palermo, Italy..

Current Problems in Cardiology
|November 6, 2022
PubMed

Insights

Early recognition and treatment of transthyretin cardiac amyloidosis (ATTR-CA) are crucial for improving prognosis. This review provides a practical guide to managing ATTR-CA, including new RNA-interfering drugs and TTR stabilizers.

Area of Science:

  • Cardiology
  • Genetics
  • Pharmacology

Background:

  • Transthyretin cardiac amyloidosis (ATTR-CA) is a restrictive cardiomyopathy caused by transthyretin (TTR) amyloid fibril deposition.
  • ATTR-CA presents in hereditary (ATTRh) and acquired (ATTRwt) forms, with a poor prognosis if untreated.
  • Early diagnosis and prompt treatment are essential for modifying the disease course.

Purpose of the Study:

  • To provide a practical guide for the treatment of ATTR cardiac amyloidosis.
  • To highlight the importance of early recognition and multidisciplinary management.
  • To review current and emerging therapeutic options for ATTR-CA.

Main Methods:

  • Review of current literature on ATTR cardiac amyloidosis diagnosis and treatment.
  • Discussion of therapeutic strategies including TTR stabilizers and RNA-interfering drugs.
  • Emphasis on a multidisciplinary approach involving various medical specialists.

Main Results:

  • Tafamidis is recommended for hereditary and wild-type TTR cardiomyopathy (NYHA Class I/II) to reduce symptoms, hospitalizations, and mortality.
  • RNA-interfering drugs like patisiran are effective for ATTRh amyloidosis, particularly with polyneuropathy.
  • Early intervention with appropriate therapies can significantly alter the prognosis of ATTR-CA.

Conclusions:

  • ATTR cardiac amyloidosis requires prompt diagnosis and a multidisciplinary treatment strategy.
  • Tafamidis and patisiran represent significant advancements in managing ATTR-CA.
  • This review serves as a practical resource for clinicians managing patients with ATTR cardiac amyloidosis.

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