Featured Article| Volume 19, ISSUE 2, 104480, February 2023

Pharmacological Management of Transthyretin Cardiac Amyloidosis

Published:November 17, 2022DOI:


      • Cardiac amyloidosis is underdiagnosed and often mistreated as heart failure.
      • Tafamidis is a transthyretin (TTR) stabilizer that inhibits its misfolding into amyloid fibrils.
      • Tafamidis lowers risk of all-cause mortality and cardiovascular-related hospitalizations.
      • Patisiran and inotersen are silencing agents that interfere with TTR mRNA in the liver, blocking the production of unstable TTR.


      Cardiac amyloidosis is an increasingly common diagnosis characterized by the deposition of misfolded proteins in the myocardial tissue leading to progressive cardiac damage. In this article, we present evidence regarding the pharmacological management of transthyretin cardiac amyloidosis, focusing on medications that halt or regress disease progression. This article provides a brief overview of the medications, such as diuretics, anticoagulants, and antiarrhythmics, used to control symptoms of heart failure as a complication of cardiac amyloidosis.


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      Mohamed Toufic El Hussein, PhD, NP, is a professor of nursing at the School of Nursing and Midwifery, Faculty of Health, Community & Education, Mount Royal University, Calgary, AB, Canada, and an acute care nurse practitioner, Medical Cardiology Coronary Care Unit, Rockyview General Hospital, Calgary, AB, Canada. He can be contacted at [email protected] and on Twitter @drmohamednp.


      Daniel Favell, BA psychology, is a nursing student in the BN program at Mount Royal University, Calgary, AB, Canada.