Predictors of all-cause mortality in chronic Chagas' heart disease in the current era of heart failure therapy

Int J Cardiol. 2008 Aug 1;128(1):22-9. doi: 10.1016/j.ijcard.2007.11.057. Epub 2008 Feb 6.

Abstract

Background and aims: 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.

Methods and 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.

Conclusion: 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.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Cardiotonic Agents / therapeutic use
  • Cause of Death
  • Chagas Cardiomyopathy / mortality*
  • Chagas Cardiomyopathy / physiopathology
  • Chronic Disease
  • Digoxin / therapeutic use
  • Female
  • Heart Failure, Systolic / mortality*
  • Heart Failure, Systolic / parasitology*
  • Heart Failure, Systolic / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • Regression Analysis
  • Risk Factors
  • Sodium / blood
  • Stroke Volume
  • Survival Analysis

Substances

  • Adrenergic beta-Antagonists
  • Cardiotonic Agents
  • Digoxin
  • Sodium