Should Cardiac Amyloids Be Screened For After Carpal Tunnel Release Surgery?

Results from a new analysis suggested that carpal tunnel syndrome was linked with amyloid deposits at the time of carpal tunnel release surgery and could be suggestive of future cardiac amyloid-related events 

Researchers for the cross-section, prospective study included consecutive men ≥50 years and women ≥60 years of age who were undergoing carpal tunnel release surgery. The authors obtained biopsy specimens of the tenosynovial tissue and stained them with Congo red to determine the prevalence and type of amyloid deposits, if any. Biopsies found with amyloid deposits were further analyzed for other biomarkers indicating cardiac involvement. The study included a total of 98 patients.  

According to the results, 10 (10.2%) of patients had a positive biopsy for amyloid presence. Two patients were diagnosed with hereditary amyloid transthyretin, two patients had cardiac involvement, and three patients were initiated on therapy. In patients with biopsy-diagnosed transthyretin amyloid, there was no difference in plasma transthyretin concentration.  

“In a cohort of patients undergoing carpal tunnel release surgery, Congo red staining of tenosynovial tissue detected amyloid deposits in 10.2% of patients,” the researchers concluded. “Concomitant cardiac evaluation identified patients with involvement of the myocardium, allowing for implementation of disease-modifying therapy.” 

Source: JACC