Prognostic impact of Chagas' disease in patients awaiting heart transplantation

Autor(es)

Bertolino, Natalia D. ^[1] ; Villafanha, Daniel F. ^[1] ; Cardinalli-Neto, Augusto ^[1] ; Cordeiro, Jose A. ^[1] ; Arcanjo, Milena J. ^[1] ; Theodoropoulos, Tatiana A. D. ^[1] ; Bestetti, Reinaldo B. ^[1]

Afiliação do(s) autor(es)

^[1] Goroka Base Hosp, BR-15090000 Sao Jose Do Rio Preto - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF HEART AND LUNG TRANSPLANTATION; v. 29, n. 4, p. 449-453, APR 2010.
• Citações Web of Science: 24

Resumo

BACKGROUND: The role of Chagas' etiology of chronic heart failure in predicting patient outcomes while awaiting heart transplantation is unknown. Accordingly, in this study we compare outcomes in Chagas' disease with non Chagas'-disease-related advanced heart failure among patients on the waiting list for heart transplantation. METHODS: We reviewed the clinical outcomes of 103 consecutive patients with chronic heart failure listed for heart transplantation from August 2000 to January 2008 at a single institution. Forty-six (44%) patients were diagnosed with Chagas' disease on the basis of positive serology. A Cox proportional hazards model was used to establish independent predictors of mortality, whereas competing risk analysis was used to estimate time-related prevalence of death and heart transplantation in Chagas' disease and non Chagas' disease patients. RESULTS: In the multivariate model, inotropic support (p < 0.0005; hazard ratio = 5.96; 95% confidence interval {[}CI] 2.41 to 14.71) and Chagas' disease etiology of heart failure (p = 0.02; hazard ratio = 2.27; 95% CI 1.14 to 4.52) were retained as independent predictors of mortality. Prevalence of death at 100 clays after listing was 30% in Chagas' disease and 16% in non Chagas' disease patients = 0.02), despite no difference in the competing rates of transplantation (30% in Chagas' and 37% in non-Chagas' patients, p = 0.5). CONCLUSIONS: Chagas' disease etiology serves as an independent predictor of mortality in patients listed for heart transplantation, with a worse outcome when compared with non Chagas' disease patients. J Heart Lung Transplant 2010;29:449-453 (C) 2010 International Society for Heart and Lung Transplantation. All rights reserved. (AU)

• Processo FAPESP: 07/58388-3 - Evolucao clinica de pacientes com cardiomiopatia chagasica na fila de espera de transplante cardiaco.
• Beneficiário: Natalia Dias Bertolino
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica