Race, Sex, and Ejection Fraction-Based Differences in Transthyretin Amyloid Cardiomyopathy (ATTR-CM) Risk Prediction

The early detection of transthyretin cardiac amyloidosis (ATTR-CM) is essential, with Tc-99m pyrophosphate scintigraphy (PYP scan) being a key diagnostic tool. Although a previously validated score has shown promise in predicting PYP scan positivity among patients with HFpEF, further evaluation in diverse cohorts is necessary. To assess the effectiveness of the ATTR-CM score in predicting PYP scan positivity within our patient population. We analyzed patients referred for PYP with SPECT at the Cleveland Clinic from January 2012 to January 2020, all of whom had undergone echocardiography within the previous year. The ATTR-CM score was determined using the following criteria: Age (60-69, +2; 70-79, +3; ≥80, +4), sex (male, +2), hypertension (present, -1), left ventricular ejection fraction (LVEF 0.57, +2). A score of ≥6 indicated high risk. Among the 540 patients (32% female, 33% black), 27% had an LVEF