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What GDMT do you recommend for patients with AL amyloidosis and systolic heart failure?

2 Answers
Mednet Member
Mednet Member
Cardiology · Memorial Sloan Kettering Cancer Center

You are correct that cardiac amyloidosis pts do not tolerate most of the GDMT. SGLT2i may be helpful for both diuresis as well as HFpEF, and we do try to start this. Generally they do not tolerate ARB/ACEI or even beta blockers. We find that torsemide seems to have better GI absorption and thus effi...

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Mednet Member
Mednet Member
Cardiology · Washington University School of Medicine

Great question and Dr. Chen has provided a great answer. There are a few things that I will add to it.

Yes, late stage cardiac amyloid patients are much more likely to be intolerant of GDMT but this a heterogenous group that may or may not have comorbid CAD, arrhythmias etc, and may variably tolerat...

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