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Predictors of mortality and heart transplantation in patients with Chagas' cardiomyopathy and ventricular tachycardia treated with implantable cardioverter-defibrillators.
Gali, Wagner L; Sarabanda, Alvaro V; Baggio, José M; Silva, Eduardo F; Gomes, Gustavo G; Junqueira, Luiz F.
Afiliação
  • Gali WL; Clinical Arrhythmia and Pacemaker Unit, Instituto de Cardiologia do Distrito Federal (IC-DF), Fundação Universitária de Cardiologia (FUC), SQSW 300 Bloco F apto 502, Brasília, Brazil.
  • Sarabanda AV; Clinical Medicine Area, Cardiology/Cardiovascular Laboratory, Faculty of Medicine, University of Brasilia, Brasília, Brazil.
  • Baggio JM; Clinical Arrhythmia and Pacemaker Unit, Instituto de Cardiologia do Distrito Federal (IC-DF), Fundação Universitária de Cardiologia (FUC), SQSW 300 Bloco F apto 502, Brasília, Brazil.
  • Silva EF; Clinical Arrhythmia and Pacemaker Unit, Instituto de Cardiologia do Distrito Federal (IC-DF), Fundação Universitária de Cardiologia (FUC), SQSW 300 Bloco F apto 502, Brasília, Brazil.
  • Gomes GG; Department of Statistics, University of Brasilia, Brasília, Brazil.
  • Junqueira LF; Clinical Arrhythmia and Pacemaker Unit, Instituto de Cardiologia do Distrito Federal (IC-DF), Fundação Universitária de Cardiologia (FUC), SQSW 300 Bloco F apto 502, Brasília, Brazil.
Europace ; 21(7): 1070-1078, 2019 Jul 01.
Article em En | MEDLINE | ID: mdl-30820579
AIMS: Data on long-term follow-up of patients with Chagas' heart disease (ChHD) receiving a secondary prevention implantable cardioverter-defibrillator (ICD) are limited and its benefit is controversial. The aim of this study was to evaluate the long-term outcomes of ChHD patients who received a secondary prevention ICD. METHODS AND RESULTS: We assessed the outcomes of consecutive ChHD patients referred to our Institution from 2006 to 2014 for a secondary prevention ICD [89 patients; 58 men; mean age 56 ± 11 years; left ventricular ejection fraction (LVEF), 42 ± 12%]. The primary outcome included a composite of death from any cause or heart transplantation. After a mean follow-up of 59 ± 27 months, the primary outcome occurred in 23 patients (5.3% per year). Multivariate analysis showed that LVEF < 35% [hazard ratio (HR) 4.64; P < 0.01] and age ≥ 65 years (HR 3.19; P < 0.01) were independent predictors of the primary outcome. Using these two risk factors, a risk score was developed, and lower- (no risk factors), intermediate- (one risk factor), and higher-risk (two risk factors) groups were recognized with an annual rate of primary outcome of 1.4%, 7.4%, and 20.4%, respectively. A high burden of appropriate ICD therapies (16% per year) and electrical storms were documented, however, ICD interventions did not impact on the primary outcome. CONCLUSION: Among ChHD patients receiving a secondary prevention ICD, older age (≥65 years) and left ventricular dysfunction (LVEF < 35%) portend a poor outcome and were associated with increased risk of death or heart transplantation. Most patients received appropriate ICD therapies, however, ICD interventions did not impact on the primary outcome.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cardiomiopatia Chagásica / Transplante de Coração / Taquicardia Ventricular / Desfibriladores Implantáveis Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Europace Assunto da revista: CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cardiomiopatia Chagásica / Transplante de Coração / Taquicardia Ventricular / Desfibriladores Implantáveis Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Europace Assunto da revista: CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido