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Mortality risk score for patients with Chagas cardiomyopathy and pacemaker

Giselle de Lima Peixoto1, Sérgio Freitas de Siqueira1, Silvana Angelina D'Orio Nishioka1

  • 1Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.

Plos Neglected Tropical Diseases
|May 9, 2024
PubMed

Insights

This study identified key predictors of death in Chronic Chagasic Cardiomyopathy (CCC) patients with pacemakers, developing a validated risk score to assess mortality risk. The findings help stratify patients for better management of this complex cardiac condition.

Area of Science:

  • Cardiology
  • Epidemiology
  • Medical Informatics

Background:

  • Prognosis in Chronic Chagasic Cardiomyopathy (CCC) is influenced by clinical and functional factors.
  • Bradyarrhythmia requiring pacemaker implantation is a frequent complication in CCC patients.
  • Mortality risk factors and prognosis for CCC patients with pacemakers are not well-defined.

Purpose of the Study:

  • To identify predictors of all-cause mortality in a large cohort of CCC patients with pacemakers.
  • To develop and validate a risk score for predicting mortality in this specific patient population.

Main Methods:

  • An observational, unicentric, prospective study design was employed.
  • Cox regression analysis was utilized to determine mortality predictors.
  • A risk score was developed and internally validated using bootstrapping.

Main Results:

  • Predictors of mortality included right ventricular dysfunction, heart failure (NYHA class III/IV), renal disease, left ventricular end-systolic diameter > 44mm, atrial fibrillation, and cardiomegaly.
  • A risk score was created, categorizing patients into low, intermediate, and high-risk groups.
  • The predictive model demonstrated good performance with an optimism-corrected C-statistic of 0.751 and a calibration slope of 0.946.

Conclusions:

  • This study successfully identified significant predictors of mortality in CCC patients with pacemakers.
  • A simple, validated, and specific risk score was developed for this population.
  • The findings aid in risk stratification and management of CCC patients requiring pacemakers.
Abstract

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