Heart failure & cardiomyopathies
Expansion of the National Amyloidosis Centre Staging System to Detect Early Mortality in Transthyretin Cardiac Amyloidosis
Authors' conclusion
The proposed modification of the NAC staging system identifies patients with ATTR-CA at a high risk of early mortality
Study context
- Population
- Patients with transthyretin cardiac amyloidosis (ATTR-CA)
- Participants
- 2,042 patients
- Comparison
- Expanded National Amyloidosis Centre (NAC) staging for early mortality
- Stage 1n = 886reference
- Stage 2n = 706
- Stage 3n = 270
- Stage 4n = 180
- Outcome
- Mortality
- Follow-up
- 1 year
Methodological detailsOptimal NT-proBNP cut-point from time-dependent ROC curves in NAC stage 3 subgroup
- Optimal NT-proBNP cut-point from time-dependent ROC curves in NAC stage 3 subgroup
Performance
As reported in the abstract
Mortality
Hazard ratio (95% CI)
Stage 4 vs Stage 1
15.5(9.3–26.1)
Stage 4 vs Stage 3
3.4(2.2–5.4)
- Log-rank across NAC stages
- P < 0.001
Further findings
Early mortality risk by genotype, HF symptom severity and echocardiographic parameters (subgroups)
- Increased risk of early mortality consistent across subgroups
Original publication
Expansion of the National Amyloidosis Centre Staging System to Detect Early Mortality in Transthyretin Cardiac Amyloidosis. Eur J Heart Fail. Published 23 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it