Objective:

To compare red-flag clinical diagnoses preceding the diagnosis of AL and ATTRwt amyloidosis to describe differences in symptom recognition.

Approach:

Key Findings:

• AL patients were younger (mean age 68, SD 11.8) compared to ATTRwt patients (mean age 77, SD 8.1; P<.001).
• Cardiac red-flag diagnoses were more common in ATTRwt patients, with 72% having heart failure compared to 45% in AL (P<.001).
• Renal involvement was higher in AL, with 43% having chronic kidney disease versus 37% in ATTRwt (P<.001).
• Gastrointestinal symptoms were more frequent in AL, including dysphagia (18% vs 10%; P<.001) and nausea/vomiting (20% vs 12%; P<.001).
• Neurologic red flags were higher in AL, while carpal tunnel syndrome was more prevalent in ATTRwt (28% vs 12%; P<.001).

Interpretation:

Distinct clinical patterns were observed prior to diagnosis, with AL patients showing more renal and gastrointestinal symptoms, while ATTRwt patients presented more with cardiac symptoms.

Limitations:

• Reliance on ICD codes may miss subclinical manifestations and depends on healthcare recognition of red-flag diagnoses.
• Sensitivity and specificity of ICD codes for AL and ATTRwt are unknown.

Conclusion:

The study highlights the potential for using EHR data to identify patients with amyloidosis sooner.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.