Evolving Management of Transthyretin Amyloid Cardiomyopathy: From Early Recognition to Personalized Care

Abstract Transthyretin amyloid cardiomyopathy (ATTR-CM) has undergone a profound transformation over the past decade, evolving from an underrecognized and largely untreatable condition into a rapidly advancing field characterized by multiple disease-modifying therapies and an expanding therapeutic pipeline. This collection summarizes current knowledge on the biological basis of disease and its therapeutic implications, reflecting a key paradigm shift from late-stage management to early intervention. Earlier diagnosis requires a redefinition of treatment goals, from slowing progression to preserving function and preventing disease evolution. This transition highlights the need for more sensitive tools to monitor disease activity and therapeutic response. At the same time, management of comorbidities, including heart failure and atrial fibrillation, remains a critical component of care. ATTR-CM is entering a new era characterized by earlier detection, expanding therapeutic options, and increasing complexity, requiring an integrated and personalized approach.