Cardiac amyloidosis

Staging is a way to describe how serious cardiac amyloidosis is. It also helps your healthcare team know your outlook, also called prognosis. But it doesn't tell you exactly what will happen. It also doesn't say how much amyloid is in the heart. But staging can help your healthcare team plan the right treatment for you. The staging system depends on the type of cardiac amyloidosis.

Stages of AL cardiac amyloidosis

There are several staging systems available to tell how AL amyloidosis may affect a person over time. These systems use blood test results that show stress or damage to the heart, such as troponin and NT-proBNP. Some also use results from echocardiograms.

Older AL amyloidosis staging systems include the Mayo 2012 system and the European-modified Mayo 2004 system. A newer system is the AL International Staging System (AL-ISS). It was created using information from people who received newer treatments. It groups AL amyloidosis from stage 1 through stage 3C.

Staging systems continue to evolve as treatments improve. Your healthcare team can explain which system it uses and what your stage means for you.

Stages of ATTR cardiac amyloidosis

There are two commonly used systems to help stage ATTR cardiac amyloidosis.

• The Mayo Clinic staging system uses the results from NT-proBNP and troponin blood tests. The tests show if there are signs of stress or damage to the heart. This system was developed for wild-type ATTR cardiac amyloidosis. It groups the condition from stage 1 to stage 3. Stage 1 means earlier disease. Stage 3 means more serious disease.
• The National Amyloidosis Centre staging system uses NT-proBNP and a measure of kidney function called estimated glomerular filtration rate (eGFR). It can be used for both wild-type and hereditary ATTR cardiac amyloidosis. It groups the condition from stage 1 to stage 3. Stage 1 means earlier disease. Stage 3 means more serious disease. An expanded version adds stage 4, but it may not be used everywhere yet.

Your healthcare team can explain which staging system it uses. The stage is only one part of your care. Your symptoms and other test results matter too. How well you do with treatment also matters.