Study of pro-thrombotic and pro-inflammatory factors in Chagas cardiomyopathy.
BACKGROUND
The relationship between inflammatory and prothrombotic activity in chagas cardiomyopathy and in other etiologies is unclear.


OBJECTIVE
To study the profile of pro-thrombotic and pro-inflammatory markers in patients with Chagas' heart failure and compare them with patients of non-chagas etiology.


METHODS
Cross-sectional cohort.


METHODS
left ventricle ejection fraction (LVEF) < 45% and onset time to symptoms > one month. The patients were divided into two groups: group 1 (G1) - seropositive for Chagas - and group 2 (G2) - seronegative for Chagas. Pro-inflammatory factor: Ultra-sensitive CRP. Pro-thrombotic factors: thrombin-antithrombin factor, fibrinogen, von Willebrand factor antigen, plasma P-selectin and thromboelastography. Sample calculated for 80% power, assuming a standard deviation difference of 1/3; significant p if it is < 0.05.


METHODS
Fisher's exact test for categorical variables; unpaired Student's t-test for parametric continuous variables and Mann-Whitney test for nonparametric continuous variables.


RESULTS
Between January and June 2008, 150 patients were included, 80 in G1 and 70 in G2. Both groups maintained the averages of high sensitivity CRP above baseline values, however, there was no significant difference (p = 0.328). The fibrinogen levels were higher in G2 than in G1 (p = 0.015). Among the thromboelastography variables, the parameters MA (p=0.0013), G (p=0.0012) and TG (p =0.0005) were greater in G2 than in G1.


CONCLUSIONS
There is no evidence of greater pro-thrombotic status among patients with Chagas disease. The levels of fibrinogen and the MA, G and TG parameters of the thromboelastography point to pro-thrombotic status among non-chagas patients. Both groups had increased inflammatory activity.
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, USP.
Leila Maria Magalhães Pessoa de
LM
Melo
Germano Emílio Conceição
GE
Souza
Leandro Richa
LR
Valim
Luiz Felipe Pinho
LF
Moreira
Elbio Antonio
EA
Damico
Tania Rubia Flores da
TR
Rocha
Antonio Carlos Pereira
AC
Barretto
Celia Maria Cassaro
CM
Strunz
Edimar Alcides
EA
Bocchi
José Antonio Franchini
JA
Ramires
D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000032:analysis*; D002598:Chagas Cardiomyopathy / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D013916:Thrombelastography / Q000379:methods; D013927:Thrombosis / Q000097:blood
D015415:Biomarkers; D001779:Blood Coagulation Factors