T-Amylo Score for the Diagnosis of Transthyretin Cardiac Amyloidosis in Patients With Acute Heart Failure.

Abstract

Background and objectives: Cardiac amyloidosis due to transthyretin (ATTR-CA) is often an unrecognized cause of heart failure. Recently validated, the T-Amylo model estimates the risk of ATTR-CA. Its utility in hospitalized patients with acute heart failure (AHF), however, remains unevaluated.

Methods: A unicentric prospective study was conducted, included consecutive patients over 60 years admitted with a primary diagnosis of AHF between 2022-2024. Final diagnosis of ATTR-CA was established based on clinical and complementary results. The T-Amylo model was calculated blindly.

Results: A total of 138 patients were included, 63% of whom were men, with a mean age of 80 (standard deviation, 6.9). The diagnosis of ATTR-CA was established in 15.9% of patients. The T-Amylo predictive model showed an area under the curve of 0.93 (95% confidence interval, 0.87-0.98). 26.8% of patients were classified as low risk, with a 0% diagnosis of ATTR-CA, showing a sensitivity of 100% and specificity of 32%; 10.2% were identified as high risk, with ATTR-CA diagnosed in 78.6%, showing a sensitivity of 50% and specificity of 97.4%.

Conclusions: In AHF patients, the T-Amylo score adequately identified low- and high-risk patients for ATTR-CA. Based on readily available parameters, this model is a useful tool for detecting ATTR-CA.