Characterization Of Patients With Heart Failure Of Chagasic Etiology In An Endemic Country: An Analysis Based On The Colombian Registry Of Heart Failure.

Autor: Echeverria, Luis Eduardo, Gomez-Mesa, Juan Esteban, Rivera-Toquica, Alex, Bonfanti, Alberto Cadena, Zarama, Mario, Ramírez, Elkin Giovanni, Bustamante, Rafael, Palacio, Rolando Rolando, Ávila, Luis Manuel, Campbell, Sebastián, Morales, Lisbeth Natalia, Lopez, Juan David, Buitrago, Andres Felipe, Martinez, Erika, Saldarriaga, Clara
Zdroj: Journal of Cardiac Failure; Apr2023, Vol. 29 Issue 4, p637-637, 1p
Abstrakt: Chronic Chagasic cardiomyopathy (CCM) represents one of the most relevant causes of Heart Failure (HF) in endemic countries. This cardiomyopathy is characterized by a unique myocardial involvement and a worse prognosis than other HF etiologies. This study aims to describe the characteristics of patients with HF secondary to CCM and evaluate their prognosis using the Colombian Heart Failure Registry (RECOLFACA). RECOLFACA recruited adult patients diagnosed with HF in 60 centers in Colombia from 2017 to 2019. Baseline characteristics of patients diagnosed with CCM and those with HF of other etiologies were compared. The primary outcome was all-cause mortality. A Cox proportional hazards regression model was used to assess factors associated with the primary outcome in patients with MCC. A value of p <0.05 was considered significant. All statistical tests were two-tailed. Of the total number of patients evaluated in the RECOLFACA (n=2514), 88 (3.5%) had a CCM diagnosis. Patients with HF of Chagasic origin were significantly younger (p=0.014), had a lower prevalence of comorbidities, highlighting high blood pressure (p<0.001), Type 2 Diabetes Mellitus (T2DM) (p=0.015), coronary heart disease (p <0.001), valvulopathies (p=0.043) and dyslipidemia (p<0.001), and significantly higher severity of myocardial compromise, reflected in a worse functional class and a substantially lower ejection fraction (p=0.003), compared to those with CF of other etiologies. Finally, in a multivariate model adjusted for sex, age, NYHA classification, comorbidities, and systolic blood pressure, it was observed that the diagnosis of CCM was associated with a significantly higher risk of mortality during follow-up (HR 2.98; 95% CI 1.13-7.84). CCM represents a relevant etiology of HF in a Latin-American country, highlighting a differential clinical profile, a lower prevalence of comorbidities, and a higher risk of mortality in the short term compared to other etiologies of HF. The results of this study provide relevant information on the profile of the disease in the country, also highlighting the need to optimize the clinical-therapeutic approach to patients with CCM. [ABSTRACT FROM AUTHOR]
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