Development and Initial Results from the Canadian Cardiac Amyloidosis Pyrophosphate Imaging Registry (CAPER)

Area of Science:

• Cardiology
• Nuclear Medicine
• Medical Imaging

Background:

• Transthyretin cardiac amyloidosis (ATTR-CM) is a growing cause of heart failure in elderly individuals.
• Technetium-99m pyrophosphate (PYP) imaging is a key diagnostic tool for ATTR-CM.
• A multicenter Canadian registry was created to study ATTR-CM prevalence and diagnostic accuracy.

Purpose of the Study:

• To establish a multicenter Canadian registry for ATTR-CM research.
• To collect clinical and imaging data for patients undergoing PYP scans.
• To evaluate the accuracy of different risk scores for ATTR-CM diagnosis.

Main Methods:

• Included 2,118 patients from 4 Canadian centers undergoing [99mTc]PYP imaging.
• Collected medical history, cardiac amyloidosis red flags, and laboratory biomarkers.
• Established ATTR-CM diagnosis using standardized criteria and transferred deidentified data.

Main Results:

• ATTR-CM was diagnosed in 29.2% of patients (618/2118), with light chain amyloidosis in 5.3% (112/2118).
• The volume of [99mTc]PYP scans increased significantly from 2016 to 2022.
• The Davies et al. risk score demonstrated higher accuracy for ATTR-CM diagnosis compared to the Nitsche et al. score.

Conclusions:

• A large cohort of patients with detailed clinical and imaging data was assembled.
• The registry provides a valuable resource for ATTR-CM diagnosis and management research.
• The registry is continuously growing, promising future insights into ATTR-CM.