A silent killer of the elderly is finally being challenged—not by one treatment, but by two working in tandem to extend life and hope.
Key Points at a Glance
- Combination therapy improves survival in patients with aortic stenosis and cardiac amyloidosis
- Study shows dual treatment nearly matches outcomes of those without amyloidosis
- Researchers call for systematic screening of older heart patients for amyloidosis
- Findings published in the European Heart Journal by a global consortium
In the quiet war against aging hearts, a new strategy has emerged—and it’s rewriting what survival can look like for the oldest among us. An international team led by researchers from MedUni Vienna and University College London has found that combining two distinct therapies—heart valve replacement and a targeted drug for amyloidosis—dramatically improves outcomes for a particularly deadly duo: aortic stenosis and cardiac amyloidosis.
Aortic stenosis, where the valve leading from the heart to the rest of the body narrows dangerously, and cardiac amyloidosis, where misfolded proteins accumulate in the heart muscle, often strike together in older patients. Alone, each is serious. Together, they’re often fatal. Until now, the standard of care has focused almost exclusively on valve replacement—leaving the toxic protein deposits untouched.
But now, data from 226 patients across 10 countries offers a compelling new path. Published in the European Heart Journal, the study shows that adding tafamidis, a drug that stabilizes the misfolded proteins responsible for cardiac amyloidosis, to standard valve surgery yields powerful benefits. Patients receiving both therapies had significantly lower mortality rates. In fact, their survival mirrored that of patients who had aortic stenosis but no amyloidosis at all.
“This is the first time we’ve seen such a clear benefit from treating both conditions at once,” says Christian Nitsche, cardiologist at MedUni Vienna and lead author of the study. “It shifts how we think about care for elderly patients with complex heart disease.”
The implications go beyond treatment. The study revealed that up to 10% of patients undergoing valve replacement for aortic stenosis also had undiagnosed cardiac amyloidosis. Without screening, they’re easy to miss—and miss the benefits of tailored therapy. The researchers argue that systematic testing for amyloidosis in these patients should become standard protocol.
Cardiologists have long known the damage caused by aortic stenosis, which reduces the heart’s ability to pump blood efficiently. Amyloidosis, by stiffening the heart muscle, adds a second layer of resistance. “You’re fighting a battle on two fronts,” explains co-author Thomas Treibel from University College London. “Now we know it takes a two-pronged approach to win.”
With global populations aging, the stakes couldn’t be higher. New therapies like tafamidis come at a cost—but so does inaction. This study may serve as a call to healthcare systems to invest early in diagnostics and dual intervention, rather than face the burden of late-stage heart failure.
For now, one thing is clear: the future of heart disease treatment is more personalized, more precise, and more hopeful than ever.
Source: MedUni Vienna
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