title: Profiles of cardiovascular biomarkers according to severity stages of Chagas cardiomyopathy.
abstract: OBJECTIVE
  Up 30 to 40% of Chagas patients exhibit cardiomyopathy with different degrees of cardiac involvement. Biomarkers may help in differentiation of the severity of Chagas cardiomyopathy (CCM). This study sought to examine the diagnostic value of a panel of biomarkers to distinguish the severity of (CCM).
  
  
  METHODS
  100 patients with CCM were included in this cross-sectional study. Based on electrocardiogram and echocardiogram, CCM patients were classified in three stages according to disease's severity. Levels of high-sensitivity cardiac troponin T (Hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), soluble ST2 (sST2) and cystatin-c (Cys-c) were measured. Logistic regression models were used to assess the association between levels of natural log-transformed values of biomarkers and stages C/D versus B. We also calculated the area under curve (AUC) for each of the models.
  
  
  RESULTS
  In models adjusted for age, sex, body mass index, kidney function and medication use, increased levels of NT-proBNP (per 1 unit natural log-transformed values, odds ratio (OR)=5.55; 95CI%:1.65-18.72) and Hs-cTnT (per 1 unit natural log-transformed values, OR=7.11; 95CI%:1.41-35.90) showed significant association with the severity of CCM per 1 unit increase of biomarkers. The accuracy of NT-proBNP and Hs-cTnT for diagnosis of the severity of CCM was high: AUC of 0.968 and 0.956 respectively. No significant difference was found in the AUC between NT-proBNP and Hs-cTnT. No association was found between Gal-3, NGAL, sST2 and Cys-C and severity of CCM.
  
  
  CONCLUSIONS
  NT-proBNP and Hs-cTnT have both same diagnostic value in distinguishing severity of CCM.
authors.affiliation: Heart Failure and Heart Transplant Clinic, Fundación Cardiovascular de Colombia, Floridablanca, Colombia. Electronic address: luisecheverria@fcv.org.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Echeverría
authors.affiliation: Department of Paediatrics, Obstetrics, Gynaecology and Preventative, Universidad Autónoma de Barcelona, Barcelona, Spain; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Research Center Fundación Cardiovascular de Colombia, Floridablanca, Colombia. Electronic address: l.rojassanchez@erasmusmc.nl.
authors.forename: Lyda Z
authors.initials: LZ
authors.lastname: Rojas
authors.affiliation: Research Center Fundación Cardiovascular de Colombia, Floridablanca, Colombia. Electronic address: laurencalvo@fcv.org.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Calvo
authors.affiliation: Research Center Fundación Cardiovascular de Colombia, Floridablanca, Colombia. Electronic address: zayneroa@fcv.org.
authors.forename: Zayne M
authors.initials: ZM
authors.lastname: Roa
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Electrocardiography Research Group, Medicine School, Universidad Industrial de Santander, Bucaramanga, Colombia. Electronic address: o.ruedaochoa@erasmusmc.nl.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Rueda-Ochoa
authors.affiliation: Department of Medicine, Cardiology Division, McMaster University, PHRI-HHSC, Hamilton, Ontario, Canada. Electronic address: morillo@hhsc.ca.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Morillo
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: t.muka@erasmusmc.nl.
authors.forename: Taulant
authors.initials: T
authors.lastname: Muka
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: o.franco@erasmusmc.nl.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002598:Chagas Cardiomyopathy / Q000097:blood* / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D037502:Galectin 3; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Biomarkers; Cardiomyopathy; Chagas disease; Heart failure