Serum transthyretin as a staging biomarker in ATTR cardiomyopathy: promise, limitations, and the path forward Get access Arrow

Extract

Transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly recognized cause of heart failure with a complex and heterogeneous disease course. Accurate biological staging at first presentation remains a critical unmet need, as conventional cardiac biomarkers such as NT-proBNP and troponin reflect haemodynamic stress rather than underlying amyloid burden per se. Emerging therapies, including transthyretin (TTR) stabilizers such as tafamidis or acoramidis and RNA-silencing agents such as vutrisiran, have transformed the prognostic landscape, making early and precise disease characterization increasingly consequential for therapeutic decision-making.