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We aimed to assess the relationship between race and serum biomarkers, adverse cardiac remodeling, and outcomes in AC vs white ATTR-CA patients. 114 AC and 117 white patients confirmed ATTR-CA who underwent cardiac magnetic resonance (CMR) exam were identified. The relationship between race and the primary endpoint\u2014defined by all-cause mortality or heart failure hospitalization\u2014was assessed using Cox regression analysis. ATTR disease stage was significantly higher at diagnosis in AC vs white patients (p\u2009&lt;\u20090.0001). Left (p\u2009=\u20090.001) and right ventricular ejection fractions (p\u2009=\u20090.0002) were lower and extracellular volume (58% vs 50%) higher in AC vs white patients. At a median follow up time of 365 (IQR, 97\u2013879) days, 44% of patients had experienced the primary endpoint. AC race was strongly associated with the primary endpoint compared with White patients (HR 2.83, 95% CI 1.92\u20134.23, p\u2009&lt;\u20090.0001). AC patients were found to be at more advanced disease stages at the time of ATTR-CA diagnosis and experienced poor outcomes more frequently, highlighting the need for targeted strategies to address these health inequities.<\/jats:p>","DOI":"10.1007\/s10554-025-03436-4","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T14:43:20Z","timestamp":1749134600000},"page":"1487-1496","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Disparities in diagnosis and outcomes in American patients with transthyretin cardiac amyloidosis"],"prefix":"10.1007","volume":"41","author":[{"given":"Joyce L.","family":"Ngouchet Nouhossi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Minga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Szasz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vien T.","family":"Truong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber E.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srisha","family":"Kotlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Subashchandran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Medina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina M.","family":"Zareba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Goyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando P.","family":"Simonetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit R.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane C.","family":"Singulane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Nadig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaimaa","family":"Fadl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory R.","family":"Trankle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitasha","family":"Sarswat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hena N.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Mor-Avi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy A.","family":"Slivnick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"3436_CR1","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1056\/NEJMoa1805689","volume":"379","author":"MS Maurer","year":"2018","unstructured":"Maurer MS, Schwartz JH, Gundapaneni B et al (2018) Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. 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