N‐terminal pro‐B‐type natriuretic peptide and high‐sensitivity troponin T hold diagnostic value in cardiac amyloidosis

Aims Cardiac amyloidosis (CA) is associated with an elevation of natriuretic peptides and troponins, predicting outcome. Nevertheless, the diagnostic yield of these biomarkers has not been extensively investigated. This study aimed to evaluate the diagnostic performance for CA of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity troponin T (hs‐TnT). Methods and results Patients with suspected CA (n = 1149) underwent a diagnostic work‐up in three centres in Italy, France (n = 343, derivation cohort), and United Kingdom (n = 806, validation cohort). Biomarker values with either 100% sensitivity or ≥95% specificity were selected as rule‐out/rule‐in cut‐offs, respectively. In the derivation cohort, 227 patients (66%) had CA, and presented with higher NT‐proBNP and hs‐TnT. NT‐proBNP 180 ng/L and hs‐TnT 14 ng/L were selected as rule‐out cut‐offs, and hs‐TnT 86 ng/L as rule‐in cut‐off. NT‐proBNP