490 NT-PROBNP AND HIGH-SENSITIVITY TROPONIN T HOLD DIAGNOSTIC VALUE IN CARDIAC AMYLOIDOSIS

Abstract Background Cardiac amyloidosis (CA) is associated with an elevation of natriuretic peptides and troponins, predicting outcome. Nevertheless, the diagnostic yield these biomarkers has not been extensively investigated. Aim To evaluate performance for CA N-terminal pro-B-type peptide (NT-proBNP) high-sensitivity troponin T (hs-TnT). Methods Patients suspected (n=1,149) underwent a work-up in 3 Centers Italy, France (n=343, derivation cohort), United Kingdom (n=806, validation cohort). Biomarker values either 100% sensitivity or ≥95% specificity were selected as rule-out/rule-in cut-offs, respectively. Results In cohort, 227 patients (66%) had CA, presented higher NT-proBNP hs-TnT. 180 ng/L hs-TnT 14 rule-out 86 rule-in cut-off. <180 <14 found 7% patients, ruled out without false negatives. 20% (2% negatives) ng/L, 10% showed both below cut-offs (0.5% negatives). These refined prediction when added to echocardiographic scores hematologic disease increased wall thickness. cut-off positives). Conclusions can refine algorithm CA. reliably exclude diagnosis (Figure), overall population subgroups referred AL-CA cardiac (pseudo)hypertrophy.