Performance of Clinical Scoring Systems in the Diagnosis of Transthyretin Amyloid Cardiomyopathy in a Diverse Patient Cohort

Two diagnostic clinical scoring systems, the ATTR-CM Score and the T-AMYLO Score, have been proposed but not validated in diverse populations, despite Black race being an important risk factor for transthyretin amyloid cardiomyopathy (ATTR-CM). The aim of this study was to evaluate their performance in diagnosing ATTR-CM in a diverse patient cohort. This retrospective single-center study analyzed patients who underwent a 99mTc-pyrophosphate single photon emission computed tomography scan (Tc-PYP) for workup of suspected ATTR-CM. ATTR-CM was considered present in those exhibiting Perugini scores of 2 or 3, confirmed by myocardial radiotracer uptake via single photon emission computed tomography. The diagnostic performance of a multivariate regression model and the two scoring systems was tested against Tc-PYP as the gold standard. Our cohort included 476 patients, of which 308 (65%) were non-Hispanic Black, 93 (20%) were Hispanic, and 215 (45%) were female. A total of 164 (34%) had a positive Tc-PYP. Age ≥74 years, male sex, history of carpal tunnel, LVEF