دورية أكاديمية
أعرض في EDS

Mortality risk score for patients with Chagas cardiomyopathy and pacemaker.

التفاصيل البيبلوغرافية
العنوان: Mortality risk score for patients with Chagas cardiomyopathy and pacemaker.
المؤلفون: de Lima Peixoto G; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil., de Siqueira SF; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil., Nishioka SAD; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil., Pedrosa AAA; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil., Teixeira RA; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil., Costa R; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil., Martinelli Filho M; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
المصدر: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2024 May 09; Vol. 18 (5), pp. e0012114. Date of Electronic Publication: 2024 May 09 (Print Publication: 2024).
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Chagas Cardiomyopathy*/mortality , Pacemaker, Artificial*, Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Risk Factors ; Prognosis ; Risk Assessment ; Adult
مستخلص: Background: Prognosis of Chronic Chagasic Cardiomyopathy (CCC) patients depends on functional and clinical factors. Bradyarrhythmia requiring pacemaker is a common complication. Prognosis of these patients is poorly studied, and mortality risk factors are unknown. We aimed to identify predictors of death and to define a risk score for mortality in a large cohort of CCC patients with pacemaker.
Methods: It was an observational, unicentric and prospective study. The endpoint was all-cause mortality. Cox regression was used to identify predictors of death and to define a risk score. Bootstrapping method was used to internal score validation.
Results: We included 555 patients and after a mean follow-up of 3.7±1.5 years, 100 (18%) deaths occurred. Predictors of death were: right ventricular dysfunction (HR [hazard ratio] 2.24; 95%CI 1.41-3.53; P = 0.001); heart failure class III or IV (HR 2.16; 95% confidence interval [95%CI] 1.16-4.00; P = 0.014); renal disease (HR 2.14; 95%CI 1.24-3.68; P = 0.006); left ventricular end-systolic diameter > 44mm (HR 1.97; 95%CI 1.26-3.05; P = 0.003); atrial fibrillation (HR 1.94; 95%CI 1.25-2.99; P = 0.003) and cardiomegaly on X-ray (HR 1.87; 95%CI 1.10-3.17; P = 0.020). The score identified patients with: low (0-20 points), intermediate (21-30 points) and high risk (>31points). The optimism-corrected C-statistic of the predictive model was 0.751 (95% CI 0.696-0.806). Internal validation with bootstrapping revealed a calibration slope of 0.946 (95% CI 0.920-0.961), reflecting a small degree of over-optimism and C-statistic of 0.746 (95% CI 0.692-0.785).
Conclusions: This study identified predictors of mortality in CCC patients with pacemaker defining a simple, validated and specific risk score.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 de Lima Peixoto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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تواريخ الأحداث: Date Created: 20240509 Date Completed: 20240610 Latest Revision: 20240612
رمز التحديث: 20240612
مُعرف محوري في PubMed: PMC11164388
DOI: 10.1371/journal.pntd.0012114
PMID: 38723058
قاعدة البيانات: MEDLINE
الوصف
تدمد:1935-2735
DOI:10.1371/journal.pntd.0012114