Detecting ATTR-CM after aortic valve replacement remains a diagnostic challenge. A prospective study in Clinical Research in Cardiology found that simple clinical parameters such as age, NT-proBNP, and carpal tunnel history performed as well as the RAISE Score in identifying patients at risk.

The study analyzed 131 patients aged 60 years or older who underwent hydroxydiphosphonate bone scintigraphy after valve replacement. Pathological tracer uptake was observed in 16 percent of patients, and 8.4% were diagnosed with ATTR-CM.

A RAISE Score of 2 or higher yielded 76% sensitivity but only 56% specificity for detecting abnormal uptake. Raising the threshold to 3 or higher improved specificity to 78% but reduced sensitivity to 62%. In comparison, age of 83 years or older and the combination of carpal tunnel syndrome or NT-proBNP levels of at least 1,400 pg/mL predicted amyloid positivity with similar accuracy. These markers were also associated with higher mortality, whereas the RAISE Score was not.

The findings indicate that simple clinical factors such as age, NT-proBNP, and carpal tunnel history can guide amyloidosis screening after valve replacement.