The predicting system of prognosis for transthyretin amyloid cardiomyopathy

Abstract

Abstract Background The staging systems for transthyretin amyloid cardiomyopathy (ATTR-CM) by high sensitivity cardiac troponin T (hs-cTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and estimated glomerular filtration rate (eGFR) are established. However, this system is not validated in Japan. Purpose The aim of study was to validate and modify the predicting system by BNP, hs-cTnT and eGFR of prognosis for Japanese patients with ATTRwt-CM. Method We evaluated in 158 consecutive patients with wild-type ATTR-CM. Univariate analysis revealed that increased hs-cTnT and B-type natriuretic peptide (BNP) levels and impaired renal function at diagnosis were associated with poor prognosis. We defined best cutoff value as follows by ROC curve analysis; hs-cTnT >0.0565 ng/mL, BNP >285 pg/mL and eGFR <45 mL/min. We scored the index by adding 1 point for each factor and divide into low score group (0–1 point) and high score group (2–3 points). Result As shown figure, high score was associated with increased all-cause mortality and heart failure rehospitalization (log rank; P<0.001, respectively). Conclusion This simple scoring system by hs-cTnT, BNP and eGFR, was useful for predicting prognosis in patients with wild-type ATTR-CM. Funding Acknowledgement Type of funding sources: None.