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Transthyretin amyloidosis (ATTR) is a rapidly evolving disease with a rising prevalence and improving prognosis. With an increasing number of patients diagnosed across a broad spectrum of disease stages, disease prognostication is pivotal to guiding therapeutic decisions. Similarly, with varying phenotypes identified and an expanding range of disease-modifying treatments available, the timely identification of cardiac and extracardiac disease progression remains essential. In this review, the authors highlight the current state of knowledge for disease prognosis and progression in ATTR