**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Trejeeve Martyn, MD MSc
Cleveland Clinic
Cleveland, OHIO, 44195

**Main Body of the Abstract**
Background
Early diagnosis of transthyretin cardiac amyloidosis is crucial, particularly with the availability of disease-modifying therapies. Tc-99m pyrophosphate scintigraphy (PYP scan) is widely used for diagnosis. A previously validated score derived from a predominantly male cohort (80%) has shown promise in predicting PYP scan positivity in patients with HFpEF. Our aim was to evaluate the performance of the ATTR-CM score across sex.
Methods
We included patients referred for PYP with SPECT at our institution between 2012 and 2020, with an echocardiogram within one year. The ATTR-CM score was calculated with the following variables: Age (if 60-69, +2; if 70-79, +3, if ≥80, +4), Sex (if Male, +2), Hypertension (if present, -1), Ejection Fraction (if <60%, +1), Posterior Wall Thickness (if ≥12 mm, +1) and Relative Wall Thickness (if >0.57, +2). A score ≥6 was considered high-risk.
Results
The cohort consisted of 540 patients (68% male). The prevalence of ATTR-CM was significantly higher in men (34% vs 16%). The score showed good discrimination with an AUC of 0.820 in women and 0.806 in men. For a score ≥6, sensitivity was 86% in men and 37% in women. However, for a score ≥5, sensitivity increased to 82% in women and 93% in men.
Conclusion
The performance of the ATTR-CM score by AUC was consistently good across our cohort. However, it was less sensitive for detecting disease in women, suggesting the need for a sex-specific cutoff. Efforts to scale ATTR-CM diagnosis tools should be mindful of sex differences.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Trejeeve Martyn, MD MSc
Cleveland Clinic
Cleveland, OHIO, 44195

**Main Body of the Abstract**
**Background**
Early diagnosis of transthyretin cardiac amyloidosis is crucial, particularly with the availability of disease-modifying therapies. Tc-99m pyrophosphate scintigraphy (PYP scan) is widely used for diagnosis. A previously validated score derived from a predominantly male cohort (80%) has shown promise in predicting PYP scan positivity in patients with HFpEF. Our aim was to evaluate the performance of the ATTR-CM score across sex.
**Methods**
We included patients referred for PYP with SPECT at our institution between 2012 and 2020, with an echocardiogram within one year. The ATTR-CM score was calculated with the following variables: Age (if 60-69, +2; if 70-79, +3, if ≥80, +4), Sex (if Male, +2), Hypertension (if present, -1), Ejection Fraction (if <60%, +1), Posterior Wall Thickness (if ≥12 mm, +1) and Relative Wall Thickness (if >0.57, +2). A score ≥6 was considered high-risk.
**Results**
The cohort consisted of 540 patients (68% male). The prevalence of ATTR-CM was significantly higher in men (34% vs 16%). The score showed good discrimination with an AUC of 0.820 in women and 0.806 in men. For a score ≥6, sensitivity was 86% in men and 37% in women. However, for a score ≥5, sensitivity increased to 82% in women and 93% in men.
**Conclusion**
The performance of the ATTR-CM score by AUC was consistently good across our cohort. However, it was less sensitive for detecting disease in women, suggesting the need for a sex-specific cutoff. Efforts to scale ATTR-CM diagnosis tools should be mindful of sex differences.



Sex differences in the performance of the transthyretin amyloid cardiomyopathy (ATTR-CM) risk score PA4 (#122)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.