Marques, NunoAzevedo, Olga2026-04-302026-04-302025-020870-2551http://hdl.handle.net/10400.1/28825Transthyretin amyloidosis (ATTR) is caused by the extracellular deposition of amyloid fibrils of wild-type (ATTRwt) or variant (ATTRv) transthyretin (TTR). While ATTRwt amyloidosis is essentially a cardiac disease, ATTRv amyloidosis may present with different phenotypes, ranging from predominantly cardiac to predominantly neurologic, or even mixed phenotypes, depending on the TTR gene variant.1---3 Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive cardiomyopathy that causes heart failure, dysrhythmias and conduction block, which eventually lead to death.1 Median survival following diagnosis in untreated patients with ATTR-CM is 3.6---4.8 years in the wild-type form, 2.6 years in ATTR-CM due to the Val142Ile variant and 5.8 years in ATTR-CM caused by other TTR variants.4,5 To improve the prognosis of ATTR-CM, it is important to implement strategic measures that (i) increase awareness of ATTR amyloidosis, (ii) ensure early referral of cases with suspicion of ATTR-CM, (iii) promote early screening, diagnosis and treatment of ATTR-CM, and (iv) assure appropriate symptomatic management of the disease. However, some questions remain concerning who should be screened for ATTR-CM, and international recommendations differ regarding the red flags that should prompt screening for ATTR-CM.6engjournal article10.1016/j.repc.2024.11.010