Original Investigation

Transthyretin Cardiac Amyloidosis in Older Black and Hispanic Individuals With Heart Failure

JAMA Cardiology 10.1001/jamacardio.2025.2948

September 10, 2025 at 11:00 AM EDT

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What is the prevalence of transthyretin cardiac amyloidosis (ATTR-CA) and the proportion of ATTR-CA attributable to the common hereditary gene variant V142I among Black and Caribbean Hispanic patients with heart failure (HF) aged 60 years and older?In this cross-sectional study, among 646 participants with median (IQR) age 73 (66-80) years, ATTR-CA was the cause of HF in 7.8% of Black participants overall and 17.2% of Black participants older than 75 years, but only 2.2% of Hispanic participants. Wild-type ATTR-CA was more common (55.8%) than abnormal hereditary V142I ATTR-CA (ATTRv-CA, 44.2%); among V142I genotype carriers with HF, the phenotype of ATTRv-CA was present in 52.8%.Older men were more likely to have ATTR-CA and penetrant V142I disease, and the presence of V142I alone was insufficient to identify ATTR-CA in this at-risk population.

Corresponding Author: Frederick L. Ruberg, MD, Section of Cardiovascular Medicine, Boston Medical Center, 72 E Concord St, Boston, MA 02118 (frruberg@bu.edu).

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