Delayed Diagnosis Common in ATTR-CM, Study Finds

Researchers assessed the time for initial clinical manifestation to transthyretin (TTR) amyloid cardiomyopathy (ATTR-CM). The findings were presented at European Society of Cardiology (ESC) Heart Failure 2025.

“Early diagnosis of ATTR-CM is challenging because the associated symptoms and clinical manifestations are nonspecific and overlap with other conditions,” the researchers wrote.

In this retrospective observational cohort study, researchers used the Komodo Healthcare Map to analyze 8,573 patients aged 50 years and older who had at least two diagnosis claims for ATTR-CM and at least two claims with a cardiac-related diagnosis code or at least one prescription claim for tafamidis.

Moreover, patients were required to have at least 3 years of continuous enrollment before the index date, which was defined as the first occurrence of an ATTR-CM diagnosis code or tafamidis claim. The investigators noted that the time from the first recorded clinical manifestation until ATTR-CM diagnosis was defined by the first ICD-10-CM code for a condition of interest before the index date.

The findings showed that of the 27 clinical manifestations of interest, patients had an average of eight manifestations before the diagnosis of ATTR-CM was made, and the median time from the first observed clinical manifestation to diagnosis was 57.6 months, the investigators noted. Autonomic dysfunction, elevated B-type natriuretic peptide, and heart failure were linked with the shortest median time between recorded condition and ATTR-CM diagnosis (22.3, 23.4, and 25.1 months, respectively).

“Our study demonstrates that the patient journey to an ATTR-CM diagnosis can be prolonged and challenging, which potentially leads to more severe disease at diagnosis. Understanding the factors contributing to diagnostic delays is important to improving diagnostic pathways and patient outcomes,” the researchers concluded.