Clinical Report: CTS Surgery Biopsies May Identify Early ATTR-CM
Overview
A multicenter cohort study indicates that biopsy-guided screening during carpal tunnel surgery can detect transthyretin amyloid cardiomyopathy (ATTR-CM) earlier in older patients. Among 52 patients with amyloid-positive biopsies, 17% were diagnosed with ATTR-CM, primarily in asymptomatic stages.
Background
Transthyretin amyloid cardiomyopathy (ATTR-CM) is often underdiagnosed, particularly in older adults. Early identification is crucial for managing the disease effectively, as it can lead to better patient outcomes. This study explores the potential of surgical biopsies during carpal tunnel syndrome procedures to facilitate earlier diagnosis.
Data Highlights
Parameter
Value
Total patients
109
Amyloid-positive biopsies
61 (56%)
Diagnosed with ATTR-CM
9 (17%)
Asymptomatic patients
7 of 9 (78%)
Follow-up duration
2.3 years
Key Findings
17% of patients with amyloid-positive biopsies were diagnosed with ATTR-CM.
89% of screening-detected patients were classified as National Amyloidosis Centre stage I.
Most patients identified through screening were asymptomatic (78% in NYHA class I).
Screening identified a higher proportion of women compared to usual clinical pathways (22% vs. 4%).
Lower biomarker levels and less structural cardiac involvement were noted in screening-detected patients.
Clinical Implications
The findings suggest that implementing biopsy-guided screening during carpal tunnel surgery could enhance early detection of ATTR-CM, particularly in older patients. Clinicians should consider this approach in high-risk populations to potentially improve management strategies.
Conclusion
This study highlights the utility of surgical biopsies in identifying early-stage ATTR-CM, emphasizing the need for awareness and screening in older patients undergoing carpal tunnel surgery.
