Decompensated chagasic heart failure versus non-chagasic heart failure at a tertiary care hospital: Clinical characteristics and outcomes

作者：Borges Azevedo dos Santos Luiza Nauane; Rocha Mario de Seixas; de Oliveira Eloina Nunes; Gusmao de Moura Carlos Antnio; Santos de Araujo Ayslan Jorge; Gusmao Italo Magalhaes; Feitosa Filho Gilson Soares; Sampaio Cruz Constana Margarida

来源：Revista da Associacao Medica Brasileira, 2017, 63(1): 57-63.

DOI：10.1590/1806-9282.63.01.57

• heart failure
• chagas cardiomyopathy
• patient readmission

Objective: To evaluate clinical and epidemiological characteristics and clinical outcomes in patients hospitalized with decompensated heart failure (DHF), with a comparison between Chagas and non-Chagas disease.
Method: This is a retrospective cohort study involving 136 patients consecutively admitted with DHF between January 1 and December 31, 2011, with the following outcomes: acute renal failure, cardiogenic shock, rehospitalization, and hospital death. Individuals aged >= 18 years with DHF were included while those with more than 10% of missing data regarding outcomes were excluded. Statistical analysis was performed using SPSS version 17.0. Chi-squared test was used to compare proportions. Student's T test was used to compare means. Kaplan-Meier and log-rank tests were used to compare rehospitalization rates between the two groups over time.
Results: Chagasic and non-chagasic patients were compared. The first had lower mean systolic blood pressure (111.8 +/- 18.4 versus 128.8 +/- 24.4, p< 0.01), lower mean diastolic blood pressure (74.5 +/- 13.6 versus 82.0 +/- 15.2, p< 0.01) and lower left ventricular ejection fraction (26.5 +/- 6.2 versus 41.5 +/- 18.9, p< 0.01). In all, 20 patients with Chagas (50.1%) were rehospitalized, compared to 35 patients in the non-Chagas group (35.4%, p= 0.04). Log rank test = 4.5 (p< 0.01) showed that rehospitalization rates between the two groups over time (Kaplan-Meier curves) differed.
Conclusion: Chagas disease was associated with lower systolic and diastolic blood pressure and lower left ventricular ejection fraction. The rehospitalization rate was higher in Chagas disease.

• 出版日期2017-1