Timeliness of Transthyretin Cardiac Amyloidosis Diagnosis in the Medicare Population

Among patients in the Medicare fee-for-service database with transthyretin cardiac amyloidosis (ATTR-CM), how long is the delay between initial heart failure (HF) diagnosis and subsequent ATTR-CM diagnosis, and what factors are associated with delayed diagnosis?In this cohort study of 7770 Medicare enrollees with ATTR-CM, most patients experienced a delay of longer than 6 months, and diagnostic delay did not improve over time. Female sex, aortic stenosis, chronic obstructive pulmonary disease, coronary artery disease, diabetes, and hypertension were associated with a statistically significant higher odds of delayed diagnosis.The findings of substantial and persistent diagnostic delays highlight the need for improved evaluation strategies to recognize ATTR-CM earlier in patients presenting with HF, particularly for women and patients with comorbidities associated with HF.

Corresponding Author: Alexander T. Sandhu, MD, MS, Division of Cardiology, Department of Medicine, University of California, Los Angeles, 1100 Glendon Avenue, Suite 1820, Los Angeles, CA 90095(atsandhu@mednet.ucla.edu).

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