Transthyretin cardiac amyloidosis (CA) is associated with an increased frequency of heart failure but not with increased risk of death among individuals with African ancestry. Unexplained left ventricular (LV) hypertrophy raises the suspicion of CA. Recently, a transversal survey held in Martinique and Guadeloupe found a high frequency of CA among these patients. This preliminary report addresses the risk of death associated with diagnosis of CA in these patients.

The TEAM-study prospectively held in 3 hospitals in Guadeloupe and Martinique from January 2013 to June 2014 screened cardiac amyloidosis in patients with left ventricular wall thickness equal or greater than 15mm, or wall sparkling. Among the 168 participants from Martinique, 51 were eventually diagnosed with cardiac amyloidosis, 44 of them with transthyretin CA. The vital status was determined as of July 2018, mainly by checking the PMSI data, which traces hospitalization and ambulatory visits in all public hospitals in Martinique. Patients whose data were not available were contacted by telephone. Information about the cause of death was collected. Kaplan–Meier curves and Cox analyses were performed.

In this preliminary report, vital status was checked among 113 participants, 41 with CA, 72 with unexplained LVH (Unexp). There was no significant difference between these 113 and the remaining other patients. Mean follow-up was 46.1 months. Death occurred in 24 (59%) of the CA patients and 17 (23.6%) of the Unexp. The median survival after diagnosis was 2.8 years in the CA patients, and exceeded follow-up in the Unexp. Factors associated with survival in univariate analyses were CA, severe NYHA status, troponine and ProBNP values, cardiac output, and Sokolow indice. In multivariate analysis, CA carried a higher risk of death (HR=3.21 [1.47; 7.04]). NYHA status was the only other significant factor.

Diagnosis of CA among patients with LVH implies reduced survival.