Joshua Mitchell

Cardiologist at Washington University in St. Louis. #CardioOnc, evidence-based medicine, prevention, patient advocacy. Army veteran (#RLTW). Opinions my own.

[PeerView @PeerView]

Watch @joshmitchellmd & @jvaishnavmd discuss the latest #ATTR-CA updates during #HFSA2026 - to participate, visit: https://t.co/6NnSJrSWmO https://t.co/oSsK0Vaazs

[OncoDaily @oncodaily]

GCOS 2026 — Amyloidosis Session Update: Advancing ATTR Treatment

The session highlighted how modern therapies are reshaping outcomes in ATTR cardiac amyloidosis. The discussion returned to the core biology: transthyretin becomes harmful when it destabilizes and misfolds, forming fibrils that damage organs. Current treatments work by either reducing TTR production or stabilizing the protein to prevent misfolding.

Across trials, all approved therapies show meaningful reductions in mortality, cardiovascular events, and functional decline. Early separation of outcome curves — sometimes within weeks — reinforces a key message: start treatment as early as possible. Delays reduce the potential benefit.

Speakers also addressed the comparison between silencers and stabilizers. While biochemical responses may differ, real world outcomes remain nuanced, and combination therapy is not routinely recommended. Emerging agents show promise in selected groups but require further study.

A practical takeaway emphasized coordinated care: navigating approvals quickly, monitoring clinical response, and using TTR levels to confirm biological effect. The overarching message was clear — early recognition and early therapy change the trajectory of disease.

OncoDaily continues coverage from Williamsburg, bringing forward the insights shaping the future of amyloidosis care.

@ICOSociety @Ron_Witteles @joshmitchellmd

[Joshua Mitchell @joshmitchellmd]

See you tonight!

[Jen Silverman @SpeakJen]

🚨 ATTR-CA care is evolving. Are you ready?

Join @PeerView + @joshmitchellmd & @jvaishnavmd at #HFSA2026 for an #ATTRCA symposium on 10.09!

🧠 Test clinical thinking
💬 Apply the latest data
👥 Tackle real-world cases
⚡ Put evidence into practice
🔗 https://t.co/2sL3Fn1tRT

[PeerView @PeerView]

Join Joshua Mitchell, MD, MSCI (@joshmitchellmd) and Joban Vaishnav, MD (@jvaishnavmd) on 10/9 at 7:30 PM MST during #HFSA for an #ATTRCA #MedEd event: https://t.co/6NnSJrSoxg #cardiology

[PeerView @PeerView]

#ATTRCA is underdiagnosed & undertreated — but that's changing. Join Drs. Vaishnav (@jvaishnavmd) & Mitchell (@joshmitchellmd) Friday, 10/9 at #HFSA2026: https://t.co/6NnSJrSoxg #MedicalEducation

[Joshua Mitchell @joshmitchellmd]

Honored to be guest Editor-in-Chief of the #JACCCaseReports @JACCJournals special issue on #amyloidosis. Great collection of unique cases we can all learn from. See my editor's corner on important lessons and where we go from here: https://t.co/zHDo15CBkF

Full journal issue here by section: https://t.co/nifEVbFiFL

Only made possible with tremendous help from the JACC:CR team led by @GilbertTangMD and @MinnowWalsh and the amazing guest associate editors: Jose Alvarez-Cardona, @Richardkcheng2 , @MargotDavisMD @rodney_falk @MGKhouri_md @nishantshahmd @SinghVasvi @LilySternMD.

@WashUCardiology

[Dr. Gilbert Tang @GilbertTangMD]

Welcome to our SEPTEMBER 23 special sponsored issue of #JACCCaseReports @JACCJournals on cardiac #amyloidosis!
https://t.co/HEW4oV37b4.

Full PDF here:
https://t.co/Q0t0dtTcpK

Thank you @JoshMitchellMD for being our guest Editor-in-Chief!
Cardiac Amyloidosis: A Field Transformed and the Work That Remains
https://t.co/bY2ImVoIUO

@minnowalsh
@hmkyale

Imaging and Diagnostic Challenges and Pitfalls
ATTR-CM in Patients With Clinically Significant Plasma Cell Dyscrasias: A Case Series Highlighting Diagnostic Challenges
https://t.co/qX170HxA1o

Donut Morphology of Cardiac Amyloidosis: A Glazed Over Diagnosis
https://t.co/V473wF5cI2

Systemic Oxalosis Mimicking Transthyretin Amyloid Cardiomyopathy: A Cause of False Positive Tc-99m PYP Scintigraphy
https://t.co/EYDDEEWQ1p

Perugini Grade 3 Uptake Does Not Exclude AL Cardiac Amyloidosis: When Noninvasive Diagnosis Fails
https://t.co/bZaVf4HtO7

3 Discordant Extracardiac Amyloid Proteins Highlighting Bystander Deposition in a Case of Light-Chain Amyloid Cardiomyopathy
https://t.co/v0un7p2lNI

Successful Heart Transplantation in a Patient With Triple Infiltrative Cardiomyopathy: Sarcoidosis, AL and TTR Amyloidosis
https://t.co/rwU0rg30yr

Abnormal Cardiac PET Imaging in ATTR Amyloidosis
https://t.co/NDxmth36eU

Early Recognition and Atypical Presenatations
Epicardial Amyloidoma Mimicking Secondary Cardiac Lymphoma: A Sneeze Away From the Diagnosis
https://t.co/A7VSrcUn8A

Smartwatch-Detected Sinus Tachycardia Unmasking AL Cardiac Amyloidosis in a Young Adult
https://t.co/v02q1ECRpW

Transthyretin Cardiac Amyloidosis in a Safety-Net Hospital: A Case Series of 10 Afro-Caribbean Patients
https://t.co/PhlzHsihgS

Sustained Ventricular Tachycardia as the First Presentation of Hereditary Transthyretin Amyloidosis With the Glu109Gln Mutation
https://t.co/QfyoVmJWcu

Light Chain Cardiac Amyloidosis With Skeletal Muscle Weakness
https://t.co/V3ktx8vmin

Amyloid Light Chain Amyloidosis Involving the Heart and Temporal Arteries, Mimicking Giant Cell Arteritis
https://t.co/T8NVjSF2l4

Obstructive Intramural Coronary Amyloidosis: Uncommon or Under-Recognized Cause of Microvascular Angina?
https://t.co/dO6ItzDzQs

p.(V142I)-Associated Variant Transthyretin Amyloid Cardiomyopathy Complicating Complex Congenital Heart Disease: A Lethal Combination
https://t.co/yD4ve66MqQ

Hypertrophic Cardiomyopathy Overlap
Hereditary Transthyretin Cardiac Amyloidosis With Severe Left Ventricular Outflow Tract Obstruction Mimicking Hypertrophic Obstructive Cardiomyopathy
https://t.co/YmuKwdJG0R

Multimodality Imaging Reveals Rare Hereditary Transthyretin Amyloidosis Mimicking Hypertrophic Cardiomyopathy
https://t.co/3r07NQjLto

Unmasking AL Cardiac Amyloidosis During Familial Cardiomyopathy Screening
https://t.co/vmcCCRDB6J

Coexistence of Hypertrophic Cardiomyopathy and Hereditary Transthyretin Amyloid Cardiomyopathy
https://t.co/XwapP3Re2t

Management and Hemodynamics
Abnormal Cardiovascular Responses During Orthostatic Hypotension in Cardiac Amyloidosis Revealed by Semi-Sitting/Standing Stress Echocardiography
https://t.co/ZIWwwstkUY

Neurohormonal Therapy in Patients With Transthyretin Cardiac Amyloidosis: Is It an Option?
https://t.co/Cu5Zp1Ul60

Early Recovery of Cardiac Function After Hematologic Response in Systemic AL Amyloidosis
https://t.co/KQRDpKNlBz

When Hematologic Response Does Not Translate to Cardiac Recovery in AL Amyloidosis
https://t.co/DYaljl3O15

Rare Amyloid Types and Genetic ATTR Variant’s Page
Apolipoprotein A-IV Cardiac Amyloidosis: Beyond ATTR and AL
https://t.co/ndiycvpQ9t

Apolipoprotein A-IV Cardiac Amyloidosis Presenting as Massive Ventricular Wall Thickening Mimicking Hypertrophic Cardiomyopathy
https://t.co/mcTpIvn7pq

Apolipoprotein A-IV Cardiac Amyloidosis as a Diagnostic Pitfall: Beyond the Noninvasive Algorithm
https://t.co/Zwrt8MikPY

Transthyretin Amyloidosis Due to a Rare TTR Val142del Deletion With Relatively Early Clinical Manifestations
https://t.co/1oDEprQRLt

TTR Variant p.Ala65Val Causing Early-Onset Hereditary Transthyretin Amyloidosis With Mixed Cardiac and Neuropathic Phenotype
https://t.co/1oDEprQRLt

Rare Hereditary Cardiac Amyloidosis Treated With SGLT2 Inhibitor: Beyond ATTR/AL
https://t.co/I1v5tXo6al

Hereditary Transthyretin Amyloidosis in Brazilian Amazon Caused by a Globally Rare Variant Predominant in Asia
https://t.co/gIfs5ukQyz
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[PeerView @PeerView]

Join us Friday, 10/9, at 7:30 PM MST for our #ATTRCA live in-person & virtual symposium with Drs. Mitchell (@joshmitchellmd) & Vaishnav (@jvaishnavmd) at #HFSA2026: https://t.co/6NnSJrSoxg

#CardiacAmyloidosis #MedEd

[Joshua Mitchell @joshmitchellmd]

Are we doing enough for patients with #ATTR-CM? Join me and Dr. Joban Vaishnav (@jvaishnavmd) for a @PeerView live symposium on advancing transthyretin-targeted therapy — 10/9 at 7:30 PM MST in Phoenix or online during #HFSA2026: https://t.co/L60eB2hOeK #Cardiology @WashUCardiology @ICOSociety

[Joshua Mitchell @joshmitchellmd]

Honored to be able to partner with @American_Heart to discuss workable strategies to improve #amyloid recognition. Will discuss early recognition, barriers, and optimal system based practices. Register at https://t.co/YJ6Gjzzjzz. @ICOSociety @WashUCardiology @PennMedicine

[markusathome @MarkusAtHome]

Immune Checkpoint Inhibitor–Associated Cardiovascular Toxic Effects by Drs.
@mayocvonc, @joshmitchellmd et al.

An International Cardio-Oncology Society Position Statement:

https://t.co/efX2eH93p0

[Joshua Mitchell @joshmitchellmd]

I am always in awe of the team we have on the @ICOSociety Scientific and Research Committee. Such a fantastic group of international collaborators. Really enjoyed working on this position statement with them. Great content in the manuscript and supplement!

#cardiooncology https://t.co/2lOpuNByk3

[International Cardio-Oncology Society @ICOSociety]

📰 HOT OFF THE PRESSES 📰

Immune Checkpoint Inhibitor (#ICIs) treatments are known to potentially cause harm to the heart, particularly through conditions like #myocarditis.

Today in @JAMAOnc, we stressed the importance of interdisciplinary collaboration as the best way to mitigate effects and protect the #hearts of #cancer patients.

Read the positioning statement: https://t.co/2SktP5Q75j

[Raja Zaghlol @RajaZaghlol]

Check out our publication in #CardioOncology. Atrial fibrillation/flutter in stem cell transplant patients. Prevalence, association with outcomes, and impact on healthcare resource-utilization/readmissions. @joshmitchellmd @Teebi_MD
https://t.co/E58ilZLFdR

[Joshua Mitchell @joshmitchellmd]

@RajaZaghlol, a fantastic @WashUCardiology fellow, led this impactful study on afib in stem cell tx patients. Patients with afib were 3-4x more likely to die in the hospital, and 50% more likely to die in 90 days after discharge. Congrats! @ICOSociety #cardioonc

[@SN_Oncology @SN_Oncology]

🚨Recently published in #CardioOncology

Atrial fibrillation or flutter in patients undergoing stem cell transplantation, in-hospital and post-discharge outcomes in a large nationwide sample across the United States🔍

#OpenAccess #CardiovascularHealth

👉https://t.co/K8p0JqgqCt

[Benjamin Kopecky @BKopeckyMDPhD]

3 years ago my good friend @MorenoMDPhD approached me about this crazy idea to fill a much needed gap in heart failure education (1/3).

[Joshua Mitchell @joshmitchellmd]

Congrats to Matt Lui, outstanding @WashUCardiology fellow, on his study showing that a visual review of CAC on NSCLC RAD planning CT was more predictive of CV events than Rad dose. Visual review ~ formal CAC score. #cardioonc @ICOSociety @SBRT_CR

https://t.co/AtKhO3kAaS

[Joshua Mitchell @joshmitchellmd]

Congrats to @RajaZaghlol for leading our contemporary review of CV complications from radiation therapy including historic trends and current recs. Always great to work with @carmenbergom @DrLPedersen and @yoo_sgkyle! #cardioonc @WashUCardiology

https://t.co/ymRjawVAfM

[Joshua Mitchell @joshmitchellmd]

Congrats to @gwalls89 for an excellent manuscript detailing the practice patterns and general uptake of guidelines in #radonc internationally. Interesting insights! #cardioonc @icosociety @gerryhanna

https://t.co/VjL5Wzj8pL