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PLASMA B-TYPE NATRIURETIC PEPTIDE AS A PREDICTOR OF MORTALITY IN COMMUNITY-DWELLING OLDER ADULTS WITH CHAGAS DISEASE: 10-YEAR FOLLOW-UP OF THE BAMBUI COHORT STUDY OF AGING
Chagas disease
cohort studies
mortality
natriuretic peptides
prognosis
Trypanosoma cruzi
Autor
Afiliación
Fundação Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Belo Horizonte, MG, Brazil / Universidade Federal de Ouro Preto. Escola de Nutrição, Ouro Preto, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciencias Exatas. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Hospital das Clınicas. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Centro de Pesquisas Rene Rachou. Belo Horizonte, MG, Brazil / Universidade Federal de Ouro Preto. Escola de Nutrição, Ouro Preto, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciencias Exatas. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Hospital das Clınicas. Belo Horizonte, MG, Brazil.
Resumen en ingles
In this study, the authors aimed to investigate the prognostic value of b-type natriuretic peptide (BNP) for all-cause mortality among persons with Chagas disease, a parasitic disease caused by the protozo na Trypanosoma cruzi. The authors used data on 1,398 participants (37.5% infected with T. cruzi) aged 60 years and over from the Bambuı´Cohort Study of Aging in Brazil. From 1997 to 2007, 512 participants died, leading to 12,406 person-years of observation. The hazard ratio for death was 1.27 for each unit of log-transformed BNP level (95% confidence interval (CI: 1.11, 1.45) among infected persons, independent of potentially confounding factors. Infected persons with baseline BNP levels in the top quartile had a risk of death twice that of persons in the bottom quartile (hazard ratio ¼ 2.07, 95% CI: 1.29, 3.32). The discriminatory ability of BNP in predicting mortality (C¼0.69, 95% CI: 0.66, 0.71) was similar to that of an electrocardiogram (C¼0.68, 95% CI: 0.65, 0.71), with reasonably stable risk discrimination over time. BNP is a strong predictor of mortality in older adults with Chagas disease. Although the usefulness of BNP for risk stratification in this parasitic disease remains a topic of debate, this study found that BNP-based risk discrimination is at least comparable to that of an electrocardiogram.
Palabras clave en ingles
AgedChagas disease
cohort studies
mortality
natriuretic peptides
prognosis
Trypanosoma cruzi
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