Key result
Higher sTNFR2 levels predict greater risk of major events in chronic Chagas cardiomyopathy.
Why the study?
Soluble tumor necrosis factor receptors correlate with cardiac and functional parameters in chronic Chagas cardiomyopathy, but their prognostic value remains unknown.
Do soluble TNF receptors (sTNFR1 and sTNFR2) predict adverse cardiovascular events in patients with Chronic Chagas cardiomyopathy?
Observational (n=69)
Do soluble TNF receptors (sTNFR1 and sTNFR2) predict adverse cardiovascular events in patients with Chronic Chagas cardiomyopathy?
High serum levels of sTNFR2, along with lower LVEF, are strong independent predictors of adverse cardiovascular events in patients with Chronic Chagas cardiomyopathy.
BACKGROUND: Chronic Chagas cardiomyopathy (CCC) is the most severe clinical form of the Chagas disease. There is a strong correlation between soluble tumor necrosis factor receptors (sTNFR1 and sTNFR2) and cardiac and functional parameters in CCC, but their prognostic value remains unknown. OBJECTIVE: To verify the prognostic value of sTNFR1 and sTNFR2 in CCC. METHODS: A longitudinal study was conducted. Sixty-nine patients with CCC (53.70 ± 9.66 years, NYHA I-II) were submitted to blood collection and echocardiography, and followed for 43.81 ± 1.21 months. The outcome was determined by the combination of cardiac death, heart transplantation, or stroke. FINDINGS: After the follow-up, 15 patients (22%) presented adverse cardiovascular events. Only left ventricular ejection fraction (LVEF) [heart rate at rest (HR): 0.935, 95% CI 0.878 to 0.994; p = 0.033] and sTNFR2 (HR: 1.002, 95% CI 1.001 to 1.003; p = 0.006) remained as independent predictors of adverse cardiovascular events. The optimal cutoff point to identify these patients was the value of 1784.00 pg/mL. There was a significant difference between the groups with lower and higher sTNFR2 levels (long-rank < 0.001). MAIN CONCLUSIONS: High serum levels of sTNFR2, together with lower LVEF, are strong independent predictors of adverse cardiovascular events in CCC, making them valuable for risk stratification.
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Ávila et al. (2025) conducted an observational in Chronic Chagas cardiomyopathy (n=69). sTNFR2 vs. lower sTNFR2 levels was evaluated on combination of cardiac death, heart transplantation, or stroke (HR 1.002, 95% CI 1.001-1.003, p=0.006). Higher serum levels of sTNFR2 independently predicted the composite of cardiac death, heart transplantation, or stroke in Chronic Chagas cardiomyopathy (HR 1.002; 95% CI 1.001-1.003; p=0.006).
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