title: Plasma B-type natriuretic peptide as a predictor of mortality in community-dwelling older adults with Chagas disease: 10-year follow-up of the Bambui Cohort Study of Aging.
abstract: In this study, the authors aimed to investigate the prognostic value of brain-type natriuretic peptide (BNP) for all-cause mortality among persons with Chagas disease, a parasitic disease caused by the protozoan Trypanosoma cruzi. The authors used data on 1,398 participants (37.5% infected with T. cruzi) aged 60 years and over from the Bambuí Cohort Study of Aging in Brazil. From 1997 to 2007, 512 participants died, leading to 12,406 person-years of observation. The hazard ratio for death was 1.27 for each unit of log-transformed BNP level (95% confidence interval (CI: 1.11, 1.45) among infected persons, independent of potentially confounding factors. Infected persons with baseline BNP levels in the top quartile had a risk of death twice that of persons in the bottom quartile (hazard ratio = 2.07, 95% CI: 1.29, 3.32). The discriminatory ability of BNP in predicting mortality (C = 0.69, 95% CI: 0.66, 0.71) was similar to that of an electrocardiogram (C = 0.68, 95% CI: 0.65, 0.71), with reasonably stable risk discrimination over time. BNP is a strong predictor of mortality in older adults with Chagas disease. Although the usefulness of BNP for risk stratification in this parasitic disease remains a topic of debate, this study found that BNP-based risk discrimination is at least comparable to that of an electrocardiogram.
authors.affiliation: Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil. lima-costa@cpqrr.fiocruz.br
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Lima-Costa
authors.forename: Cibele C
authors.initials: CC
authors.lastname: Cesar
authors.forename: Sérgio Viana
authors.initials: SV
authors.lastname: Peixoto
authors.forename: Antonio Luiz P
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D000368:Aged; D000375:Aging; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D001938:Brazil; D014355:Chagas Disease / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*; D015331:Cohort Studies; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007199:Indians, South American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012111:Residence Characteristics; D012907:Smoking / Q000009:adverse effects
chemical_list: D000981:Antiprotozoal Agents; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain