Predictors of all-cause mortality in chronic Chagas' heart disease in the current era of heart failure therapy

Abstract Background and aims We sought to identify predictors of all-cause mortality for Chagas' disease patients with chronic systolic heart failure because they are virtually lacking in the current era of heart failure therapy. Methods and results This study focus on 127 patients with the diagnosis of chronic systolic heart failure secondary to Chagas' cardiomyopathy. Mean follow up was 25±19 months. Sixty-three (50%) patients died during the study period. Cox regression analysis showed lack of B-blocking agent use ( p =0.002, hazard ratio=0.30, 95% Confidence Interval 0.14 to 0.64), serum sodium levels ( p =0.01, hazard ratio=0.93, 95% Confidence Interval 0.87 to 0.98), left ventricular ejection fraction ( p =0.02, hazard ratio=0.96, 95% Confidence Interval 0.93 to 0.99), digoxin treatment ( p =0.04, hazard ratio=8.47, 95% Confidence Interval 1.13 to 62.52) and New York Heart Association Class IV on admission ( p =0.034, hazard ratio=1.92, 95% Confidence Interval 1.02 to 3.51) independent predictors of all-cause mortality. Conclusion Lack of B-blocking agent use, serum sodium levels, left ventricular ejection fraction, digoxin treatment and New York Heart Association Class IV are independent predictors of all-cause mortality for patients with chronic heart failure secondary to Chagas' cardiomyopathy in the current era of heart failure therapy.