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Prognostic impact of Chagas' disease in patients awaiting heart transplantation

Natália D Bertolino1, Daniel F Villafanha, Augusto Cardinalli-Neto

  • 1Hospital de Base, São José do Rio Preto city, Brazil.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|December 17, 2009
PubMed

Insights

Chagas

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Infectious Diseases

Background:

  • The prognostic value of Chagas' disease in advanced heart failure patients awaiting heart transplantation remains unclear.
  • This study compares outcomes for patients with Chagas' disease-related versus non-Chagas' disease-related heart failure on the transplant waiting list.

Purpose of the Study:

  • To determine if Chagas' disease etiology independently predicts mortality in patients listed for heart transplantation.
  • To compare the outcomes of heart failure patients with Chagas' disease to those without, while on the heart transplant waiting list.

Main Methods:

  • A retrospective review of 103 consecutive advanced heart failure patients listed for heart transplantation.
  • Cox proportional hazards and competing risk analyses were used to identify mortality predictors and time-to-event outcomes.
  • Forty-six patients (44%) were diagnosed with Chagas' disease via serology.

Main Results:

  • Chagas' disease etiology (hazard ratio = 2.27) and inotropic support (hazard ratio = 5.96) were independent predictors of mortality.
  • At 100 days post-listing, mortality was significantly higher in Chagas' disease patients (30%) compared to non-Chagas' disease patients (16%).
  • Transplantation rates did not differ significantly between the two groups (30% vs. 37%).

Conclusions:

  • Chagas' disease is an independent predictor of increased mortality risk in heart transplant candidates.
  • Patients with Chagas' disease heart failure experience worse outcomes while awaiting heart transplantation compared to non-Chagas' disease patients.
Abstract

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