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Medline ® Abstract for Reference 27

of 'Chagas heart disease: Treatment and prognosis'

Predictors of all-cause 1-year mortality in implantable cardioverter defibrillator patients with chronic Chagas' cardiomyopathy.
di Toro D, Muratore C, Aguinaga L, Batista L, Malan A, Greco O, Benchetrit C, Duque M, Baranchuk A, Maloney J
Pacing Clin Electrophysiol. 2011 Sep;34(9):1063-9. Epub 2011 Apr 28.
BACKGROUND: Implantable cardioverter defibrillators (ICDs) have been used in the treatment of either sustained ventricular tachycardia or ventricular fibrillation in patients with Chagas' cardiomyopathy. This study aimed at determining mortality rate and risk factors of all-cause 1-year mortality in primary and secondary ICD patients with Chagas' cardiomyopathy.
METHODS: One hundred and forty-eight Chagas' patients with ICDs were included from the Medtronic ICD Registry Latin America. All patients were followed for 1 year.
RESULTS: At implant, mean age was 60.1±9.4 years and 72.9% were male. Mean left ventricular ejection fraction (LVEF) was 40.1±11%. Mean follow-up was 12±7 months. During the follow-up, 15 patients died (10.2%). Patients who died were older (64±10.8 years vs 59±9.1; P = 0.04), had more atrial fibrillation (13.3% vs 3.8%; P = 0.02), had lower LVEF (33.4%±9.8 vs 40.9%±11.3; P = 0.01), and worse functional class (III/IV 40% vs 21.8%; P = 0.03). The multivariate analysis showed that two independent predictors of all-cause 1-year mortality remained statistically significant: age more than 65 (hazard ratio [HR]= 2.85, 95% confidence interval [CI]1.77-3.92; P = 0.03) and LVEF less than 30% (HR = 2.68, 95% CI 1.57-3.79; P = 0.04).
CONCLUSION: This analysis showed that patients older than 65 years of age and with LVEF less than 30% were independent predictors of all-cause 1-year mortality in patients with chronic Chagas' cardiomyopathy.
Hospital Argerich, Buenos Aires, Argentina. ditorodario@yahoo.com.ar