Heart failure & cardiomyopathies
Clinical Impact of Diagnostic Delay by Red Flags Assessment in Transthyretin Amyloid Cardiomyopathy
Main finding · All-cause mortalityResult — go to the resultAdjusted hazard ratio 1.07 95% CI 1.01–1.14Authors' conclusion
The median time from red-flag onset to ATTR-CM diagnosis is an independent predictor of all-cause and CV mortality. Enhancing early identification of noncardiac red flags across specialties may shorten the diagnostic pathway, facilitate earlier initiation of disease-modifying therapy, and ultimately improve clinical outcomes.
Study context
- Population
- Consecutive patients with transthyretin amyloid cardiomyopathy (ATTR-CM) from 2 referral centers in Italypatients included
- Participants
- 208 patients
- Exposure
- Longer vs shorter median time from red-flag onset to diagnosis
- Outcome
- All-cause mortality
Methodological detailsconsecutive patients, 2 referral centers in Italy
- Consecutive patients
- 2 referral centers in Italy
Main finding
All-cause mortality
Adjusted hazard ratio
1.07
95% CI 1.01–1.14
P = 0.049
Longer vs shorter median time from red-flag onset to diagnosis
adjusted HR 1.07 (95% CI 1.01–1.14); P = 0.049
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Cardiovascular (CV) mortality (secondary outcome)
| Comparison | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Longer median time from red-flag onset to diagnosis · higher risk with longer time; independently associated | 1.10 (1.02–1.18) | P = 0.025 | |
| 0.512Adjusted hazard ratio (log scale) |
Cohort characteristics
- Median age
- 80 years
- Male
- 83.7%
- Wild-type transthyretin amyloidosis
- 96.6%
Timing of red flags
- Red flags frequently emerged several years before diagnosis, with orthopedic and neurologic manifestations representing the earliest signals
Diagnostic pathways
- Cardiology referral
- 74.5%
- Diagnostic pathways were heterogeneous
Original publication
Clinical Impact of Diagnostic Delay by Red Flags Assessment in Transthyretin Amyloid Cardiomyopathy. JACC Adv. Published 2 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it