Key result
Incidental ATTR on bone scintigraphy is linked to higher overall and CV mortality.
Cohort
BACKGROUND: Transthyretin amyloidosis (ATTR) is an occasional incidental finding on bone scintigraphy. We studied its prognostic impact in elderly patients. METHODS: Technetium labeled hydroxymethylene diphosphonate (HMDP). ATTR was suspected in patients with ≥grade 2 Perugini grade uptake (grade 0-3). Heart-to-contralateral ratio (H/CL) of ≥ 1.30 was considered positive for ATTR. The overall and cardiovascular mortality were obtained from the Finnish National Statistical Service. RESULTS: There were a total of 1014 deaths (51%) and 177 cardiovascular deaths (9%) during median follow-up of 4 ± 2 years. ATTR was suspected in 69 patients (3.6%) of which 54 (2.7%) had grade 2 and 15 (.8%) had grade 3 uptake and in 47 patients (2.4%) by H/CL ratio. In multivariate analyses age, bone metastasis, H/CL ratio and grade 3 uptake were independent predictors of overall and cardiovascular mortality. Grade 2 uptake was a predictor of cardiovascular mortality. CONCLUSIONS: A suspected ATTR as an incidental finding on bone scintigraphy predicts elevated overall and cardiovascular mortality in elderly patients.
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Suomalainen et al. (2020) conducted a cohort in Incidental suspected transthyretin amyloidosis. Incidental suspected transthyretin amyloidosis (ATTR) on bone scintigraphy vs. Patients without suspected ATTR (uptake < grade 2 or H/CL < 1.30) was evaluated on Overall and cardiovascular mortality. Incidental suspected transthyretin amyloidosis on bone scintigraphy (present in 3.6% of patients) independently predicted elevated overall and cardiovascular mortality over a median of 4 years.
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