Temporal trends in the contribution of Chagas cardiomyopathy to mortality among patients with heart failure
| Autor: | Fernando Bacal, Alfredo José Mansur, Luciana Gioli-Pereira, Odilson Marcos Silvestre, Antonio Luiz Pinho Ribeiro, Fabiana G. Marcondes-Braga, Sabrina Bernardez-Pereira, Wilson Nadruz, Alexandre C. Pereira, Andrei C. Sposito, Miguel Morita Fernandes-Silva, José Eduardo Krieger, Fábio Fernandes |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Chagas Cardiomyopathy Male medicine.medical_specialty Time Factors Adolescent 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Heart rate Medicine Humans 030212 general & internal medicine Prospective Studies Aged Aged 80 and over Heart Failure Ejection fraction business.industry Mortality rate Incidence Stroke Volume Middle Aged medicine.disease Prognosis Survival Rate Blood pressure Heart failure Attributable risk Female MIOCARDIOPATIA CONGESTIVA Cardiology and Cardiovascular Medicine business Body mass index Brazil Follow-Up Studies |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| Popis: | BackgroundChagas cardiomyopathy (ChC) prevalence is decreasing in Brazil and medical therapies for heart failure (HF) have improved in the last decade. Whether these changes modified the prognosis of ChC relative to non-Chagas cardiomyopathies (NChC) remains unknown. This study evaluated the temporal trends in population attributable risk (PAR) of ChC for 2-year mortality among patients with HF enrolled at years 2002–2004 (era 1) and 2012–2014 (era 2) in a Brazilian university hospital.MethodsWe prospectively studied 362 (15% with ChC) and 582 (18% with ChC) HF patients with ejection fraction ≤50% in eras 1 and 2, respectively and estimated the PAR of ChC for 2-year mortality.ResultsThere were 145 deaths (29 in ChC) in era 1 and 85 deaths (26 in ChC) in era 2. In multivariable Cox-regression analysis adjusted for age, sex, ejection fraction, heart rate, body mass index, hypertension, diabetes mellitus, systolic blood pressure and ischaemic/valvar aetiology, ChC was associated with higher risk of death in era 1 (HR (95% CI)=1.92 (1.00 to 3.71), p=0.05) and era 2 (HR (95% CI)=3.51 (1.94 to 6.36), pConclusionAlthough the absolute death rates decreased over time in the ChC and NChC groups, the PAR of ChC for mortality increased among patients with HF, driven by increases in the HR associated with ChC. Our results highlight the need for additional efforts aiming to prevent and treat ChC. |
| Databáze: | OpenAIRE |
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