Predictors of all-cause mortality in chronic Chagas' heart disease in the current era of heart failure therapy.
OBJECTIVE
We sought to identify predictors of all-cause mortality for Chagas' disease patients with chronic systolic heart failure because they are virtually lacking in the current era of heart failure therapy.


RESULTS
This study focus on 127 patients with the diagnosis of chronic systolic heart failure secondary to Chagas' cardiomyopathy. Mean follow up was 25+/-19 months. Sixty-three (50%) patients died during the study period. Cox regression analysis showed lack of B-blocking agent use (p=0.002, hazard ratio=0.30, 95% Confidence Interval 0.14 to 0.64), serum sodium levels (p=0.01, hazard ratio=0.93, 95% Confidence Interval 0.87 to 0.98), left ventricular ejection fraction (p=0.02, hazard ratio=0.96, 95% Confidence Interval 0.93 to 0.99), digoxin treatment (p=0.04, hazard ratio=8.47, 95% Confidence Interval 1.13 to 62.52) and New York Heart Association Class IV on admission (p=0.034, hazard ratio=1.92, 95% Confidence Interval 1.02 to 3.51) independent predictors of all-cause mortality.


CONCLUSIONS
Lack of B-blocking agent use, serum sodium levels, left ventricular ejection fraction, digoxin treatment and New York Heart Association Class IV are independent predictors of all-cause mortality for patients with chronic heart failure secondary to Chagas' cardiomyopathy in the current era of heart failure therapy.
Theodoropoulos
Tatiana A D
TA
Department of Cardiology and Cardiovascular Surgery, Hospital de Base, Faculty of Medicine of São José do Rio Preto, São José do Rio Preto, Brazil.
Bestetti
Reinaldo B
RB
Otaviano
Ana Paula
AP
Cordeiro
José A
JA
Rodrigues
Vanessa C
VC
Silva
Adriana C
AC
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002423:Cause of Death; D002598:Chagas Cardiomyopathy / Q000401:mortality* / Q000503:physiopathology; D002908:Chronic Disease; D004077:Digoxin / Q000627:therapeutic use; D005260:Female; D054143:Heart Failure, Systolic / Q000401:mortality* / Q000469:parasitology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012044:Regression Analysis; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D013318:Stroke Volume; D016019:Survival Analysis
D000319:Adrenergic beta-Antagonists; D002316:Cardiotonic Agents; D004077:Digoxin; D012964:Sodium