Key result
Male gender (HR 2.81), Holter pauses ≥2 seconds (HR 3.02), increased cardiothoracic ratio (HR 7.87), and digitalis use (HR 1.41) were independent predictors for progression of Chagas cardiomyopathy.
Cohort (n=165)
Male gender, Holter pauses ≥2 seconds, increased cardiothoracic ratio, and digitalis use are independent predictors of disease progression in patients with chronic Chagas cardiomyopathy without baseline LV dysfunction.
Answers are grounded in this paper and cite their sources.
May support risk stratification in chronic Chagas cardiomyopathy; hypothesis-generating and requires prospective validation.
The identification of predictors for the progression of chronic Chagas cardiomyopathy (CCC) is essential to ensure adequate patient management. This study looked into a non-concurrent cohort of 165 CCC patients between 1985 and 2010 for independent predictors for CCC progression. The outcomes were worsening of the CCC scores and the onset of left ventricular dysfunction assessed by means of echo-Doppler cardiography. Patients were analyzed for social, demographic, epidemiologic, clinical and workup-related variables. A descriptive analysis was conducted, followed by survival curves based on univariate (Kaplan-Meier and Cox's univariate model) and multivariate (Cox regression model) analysis. Patients were followed from two to 20 years (mean: 8.2). Their mean age was 44.8 years (20-77). Comparing both iterations of the study, in the second there was a statistically significant increase in the PR interval and in the QRS duration, despite a reduction in heart rates (Wilcoxon < 0.01). The predictors for CCC progression in the final regression model were male gender (HR = 2.81), Holter monitoring showing pauses equal to or greater than two seconds (HR = 3.02) increased cardiothoracic ratio (HR = 7.87) and time of use of digitalis (HR = 1.41). Patients with multiple predictive factors require stricter follow-up and treatment.
No takes yet. Share an insight, caveat, or question.
Silva et al. (2015) conducted a cohort in Chronic Chagas cardiomyopathy (n=165). Risk factors (male gender, Holter pauses ≥2s, increased cardiothoracic ratio, digitalis use) vs. Patients without these risk factors was evaluated on Worsening of the CCC scores and the onset of left ventricular dysfunction. Male gender (HR 2.81), Holter pauses ≥2 seconds (HR 3.02), increased cardiothoracic ratio (HR 7.87), and digitalis use (HR 1.41) were independent predictors for progression of Chagas cardiomyopathy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: