ArticleJACC. CardioOncology2025
Diagnostic Performance of the New Free Light Chain Ratio in Systemic Amyloidosis.
Article in JACC. CardioOncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Light Chain Monoclonal Gammopathy of Undetermined Significance: Diagnosis, Biology, and Clinical Management.European journal of haematology · 2026Review
- Diagnostic Sensitivity of [18F]-Florbetaben-PET/CT in Detecting Cardiac Involvement in AL Amyloidosis: The Prospective MoRBiDA Study.JACC. Advances · 2026Article
- Monoclonal gammopathy exclusion in transthyretin amyloid cardiomyopathy: iStopMM estimated glomerular filtration rate-adjusted serum-free light chain ratio cut-offs.European heart journal · 2026Article
- The light chain hunt: appraising assays in AL amyloidosis.Blood advances · 2026Article
- Global validation of revised sFLC cutoffs in amyloidosis.Blood advances · 2026Article
- Refining Free Light Chain Ratio in Systemic Amyloidosis.JACC. CardioOncology · 2026Article
- Reply: Refining Free Light Chain Ratio in Systemic Amyloidosis.JACC. CardioOncology · 2026Article
- Unveiling the unseen: navigating heart involvement in amyloidosis with biomarkers beyond the horizons of imaging.European heart journal. Imaging methods and practice · 2026Review
- The FLC Ratio Reframed: Averting Unnecessary Heart Biopsies in Wild-Type ATTR Amyloidosis.JACC. CardioOncology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDetection of monoclonal components (MCs) using serum and urine immunofixation (IFE) and free light chain measurement is a critical early step in diagnosing cardiac amyloidosis. Patients with MCs are referred for biopsy-based diagnostic work-up. New reference ranges for the free light chain ratio (FLCR), adjusted for age and estimated glomerular filtration rate, have been proposed.
objectivesThe aim of this study was to compare the diagnostic performance of the new vs the conventional FLCR in patients with light chain (AL) amyloidosis and wild-type transthyretin (ATTRwt) amyloidosis.
methodsThe analysis included 1,705 patients with AL amyloidosis and 675 with ATTRwt amyloidosis.
resultsIn the AL cohort, 44 patients (3%) had negative results on serum and urine IFE at diagnosis. Among these, 13 patients had normal conventional FLCRs and 15 had normal new FLCRs, with no significant difference in diagnostic sensitivity (70.4% [95% CI: 55.8%-82.5%] vs 65.9% [95% CI: 50.0%-79.5%]; P = 0.82). Overall diagnostic sensitivity for MC detection was similar between the new and conventional FLCRs (99.2% vs 99.1%). Among patients with ATTRwt amyloidosis and negative serum and urine IFE results, 156 (26.5%) had abnormal FLCRs using the conventional cutoff, compared with only 12 (2%) using the new FLCR. At hematologic response assessment in AL amyloidosis, concordance in the definition of complete response between the 2 FLCR methods was 94.9% (95% CI: 93.4%-95.9%).
conclusionsThe new FLCR demonstrates equivalent diagnostic sensitivity in AL amyloidosis and can be integrated into complete response criteria. In patients with suspected ATTRwt amyloidosis, it significantly reduces the proportion of FLCR-only abnormalities, thereby limiting the need for biopsy confirmation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.