Cardiovascular Prognosis in Stable Patients with Cardiac Amyloidosis: A Novel and Simple Risk Score

Area of Science:

• Cardiology
• Medical Diagnostics
• Amyloidosis Research

Background:

• Cardiac amyloidosis (CA) diagnosis in stable patients often lacks tools to predict subsequent heart failure (HF) hospitalization.
• Early identification of high-risk CA outpatients is critical for optimizing follow-up and treatment.

Purpose of the Study:

• To create a straightforward, non-invasive risk score for predicting HF hospitalization in stable CA patients.
• Utilize standard electrocardiographic (ECG) and echocardiographic parameters for risk assessment.

Main Methods:

• Prospective enrollment of 100 consecutive CA patients across three centers.
• Baseline assessments included clinical data, ECG, and transthoracic echocardiography.
• Cox regression identified predictors for HF hospitalization, forming the basis of the CAMY-HF score.

Main Results:

• Over 36 months median follow-up, 55% experienced HF hospitalization; 47% died.
• Low QRS voltage, septal thickness ≥14 mm, and LVEF ≤40% independently predicted HF hospitalization.
• The CAMY-HF score (0-4) showed clear risk stratification: 0% (low-risk), 47.9% (intermediate-risk), and 80.6% (high-risk) HF hospitalization at 3 years.

Conclusions:

• The CAMY-HF score offers a simple, applicable method for early risk stratification in stable cardiac amyloidosis patients.
• Routine ECG and echocardiographic parameters enable identification of outpatients at high risk for HF hospitalization.
• This score can guide follow-up intensity and management strategies for cardiac amyloidosis.