Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study
BACKGROUND: Risk stratification of Chagas disease patients in the limited‐resource setting would be helpful in crafting management strategies. We developed a score to predict 2‐year mortality in patients with Chagas cardiomyopathy from remote endemic areas. METHODS AND RESULTS: This study enrolled 1...
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Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335521/ http://www.ncbi.nlm.nih.gov/pubmed/32157953 https://doi.org/10.1161/JAHA.119.014176 |
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ftpubmed:oai:pubmedcentral.nih.gov:7335521 2023-05-15T18:11:59+02:00 Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study Di Lorenzo Oliveira, Claudia Nunes, Maria Carmo P. Colosimo, Enrico Antonio de Lima, Emilly Malveira Cardoso, Clareci S. Ferreira, Ariela Mota de Oliveira, Lea Campos Moreira, Carlos Henrique Valente Bierrenbach, Ana Luiza Haikal, Desireé Sant′Ana Peixoto, Sérgio Viana Lima‐Costa, Maria Fernanda Sabino, Ester Cerdeira Ribeiro, Antonio Luiz P. 2020-03-11 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335521/ http://www.ncbi.nlm.nih.gov/pubmed/32157953 https://doi.org/10.1161/JAHA.119.014176 en eng John Wiley and Sons Inc. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335521/ http://www.ncbi.nlm.nih.gov/pubmed/32157953 http://dx.doi.org/10.1161/JAHA.119.014176 © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. CC-BY-NC-ND J Am Heart Assoc Original Research Text 2020 ftpubmed https://doi.org/10.1161/JAHA.119.014176 2020-07-12T00:35:44Z BACKGROUND: Risk stratification of Chagas disease patients in the limited‐resource setting would be helpful in crafting management strategies. We developed a score to predict 2‐year mortality in patients with Chagas cardiomyopathy from remote endemic areas. METHODS AND RESULTS: This study enrolled 1551 patients with Chagas cardiomyopathy from Minas Gerais State, Brazil, from the SaMi‐Trop cohort (The São Paulo‐Minas Gerais Tropical Medicine Research Center). Clinical evaluation, ECG, and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) were performed. A Cox proportional hazards model was used to develop a prediction model based on the key predictors. The end point was all‐cause mortality. The patients were classified into 3 risk categories at baseline (low, <2%; intermediate, ≥2% to 10%; high, ≥10%). External validation was performed by applying the score to an independent population with Chagas disease. After 2 years of follow‐up, 110 patients died, with an overall mortality rate of 3.505 deaths per 100 person‐years. Based on the nomogram, the independent predictors of mortality were assigned points: age (10 points per decade), New York Heart Association functional class higher than I (15 points), heart rate ≥80 beats/min (20 points), QRS duration ≥150 ms (15 points), and abnormal NT‐proBNP adjusted by age (55 points). The observed mortality rates in the low‐, intermediate‐, and high‐risk groups were 0%, 3.6%, and 32.7%, respectively, in the derivation cohort and 3.2%, 8.7%, and 19.1%, respectively, in the validation cohort. The discrimination of the score was good in the development cohort (C statistic: 0.82), and validation cohort (C statistic: 0.71). CONCLUSIONS: In a large population of patients with Chagas cardiomyopathy, a combination of risk factors accurately predicted early mortality. This helpful simple score could be used in remote areas with limited technological resources. Text sami PubMed Central (PMC) Journal of the American Heart Association 9 6 |
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Original Research Di Lorenzo Oliveira, Claudia Nunes, Maria Carmo P. Colosimo, Enrico Antonio de Lima, Emilly Malveira Cardoso, Clareci S. Ferreira, Ariela Mota de Oliveira, Lea Campos Moreira, Carlos Henrique Valente Bierrenbach, Ana Luiza Haikal, Desireé Sant′Ana Peixoto, Sérgio Viana Lima‐Costa, Maria Fernanda Sabino, Ester Cerdeira Ribeiro, Antonio Luiz P. Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study |
topic_facet |
Original Research |
description |
BACKGROUND: Risk stratification of Chagas disease patients in the limited‐resource setting would be helpful in crafting management strategies. We developed a score to predict 2‐year mortality in patients with Chagas cardiomyopathy from remote endemic areas. METHODS AND RESULTS: This study enrolled 1551 patients with Chagas cardiomyopathy from Minas Gerais State, Brazil, from the SaMi‐Trop cohort (The São Paulo‐Minas Gerais Tropical Medicine Research Center). Clinical evaluation, ECG, and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) were performed. A Cox proportional hazards model was used to develop a prediction model based on the key predictors. The end point was all‐cause mortality. The patients were classified into 3 risk categories at baseline (low, <2%; intermediate, ≥2% to 10%; high, ≥10%). External validation was performed by applying the score to an independent population with Chagas disease. After 2 years of follow‐up, 110 patients died, with an overall mortality rate of 3.505 deaths per 100 person‐years. Based on the nomogram, the independent predictors of mortality were assigned points: age (10 points per decade), New York Heart Association functional class higher than I (15 points), heart rate ≥80 beats/min (20 points), QRS duration ≥150 ms (15 points), and abnormal NT‐proBNP adjusted by age (55 points). The observed mortality rates in the low‐, intermediate‐, and high‐risk groups were 0%, 3.6%, and 32.7%, respectively, in the derivation cohort and 3.2%, 8.7%, and 19.1%, respectively, in the validation cohort. The discrimination of the score was good in the development cohort (C statistic: 0.82), and validation cohort (C statistic: 0.71). CONCLUSIONS: In a large population of patients with Chagas cardiomyopathy, a combination of risk factors accurately predicted early mortality. This helpful simple score could be used in remote areas with limited technological resources. |
format |
Text |
author |
Di Lorenzo Oliveira, Claudia Nunes, Maria Carmo P. Colosimo, Enrico Antonio de Lima, Emilly Malveira Cardoso, Clareci S. Ferreira, Ariela Mota de Oliveira, Lea Campos Moreira, Carlos Henrique Valente Bierrenbach, Ana Luiza Haikal, Desireé Sant′Ana Peixoto, Sérgio Viana Lima‐Costa, Maria Fernanda Sabino, Ester Cerdeira Ribeiro, Antonio Luiz P. |
author_facet |
Di Lorenzo Oliveira, Claudia Nunes, Maria Carmo P. Colosimo, Enrico Antonio de Lima, Emilly Malveira Cardoso, Clareci S. Ferreira, Ariela Mota de Oliveira, Lea Campos Moreira, Carlos Henrique Valente Bierrenbach, Ana Luiza Haikal, Desireé Sant′Ana Peixoto, Sérgio Viana Lima‐Costa, Maria Fernanda Sabino, Ester Cerdeira Ribeiro, Antonio Luiz P. |
author_sort |
Di Lorenzo Oliveira, Claudia |
title |
Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study |
title_short |
Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study |
title_full |
Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study |
title_fullStr |
Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study |
title_full_unstemmed |
Risk Score for Predicting 2‐Year Mortality in Patients With Chagas Cardiomyopathy From Endemic Areas: SaMi‐Trop Cohort Study |
title_sort |
risk score for predicting 2‐year mortality in patients with chagas cardiomyopathy from endemic areas: sami‐trop cohort study |
publisher |
John Wiley and Sons Inc. |
publishDate |
2020 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335521/ http://www.ncbi.nlm.nih.gov/pubmed/32157953 https://doi.org/10.1161/JAHA.119.014176 |
genre |
sami |
genre_facet |
sami |
op_source |
J Am Heart Assoc |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335521/ http://www.ncbi.nlm.nih.gov/pubmed/32157953 http://dx.doi.org/10.1161/JAHA.119.014176 |
op_rights |
© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
op_rightsnorm |
CC-BY-NC-ND |
op_doi |
https://doi.org/10.1161/JAHA.119.014176 |
container_title |
Journal of the American Heart Association |
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9 |
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6 |
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1766184563859521536 |