Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.

<h4>Background</h4>Chronic Chagas Cardiomyopathy (CCM) is a unique form of cardiomyopathy compared to other etiologies of heart failure. In CCM, risk prediction based on biomarkers has not been well-studied. We assessed the prognostic value of a biomarker panel to predict a composite out...

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Autores principales:	Luis E Echeverría, Lyda Z Rojas, Sergio Alejandro Gómez-Ochoa, Oscar L Rueda-Ochoa, Cristian David Sosa-Vesga, Taulant Muka, James L Januzzi, Rachel Marcus, Carlos A Morillo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4e92f6727d6149eaaf213ed39a6d3eb1
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spelling	oai:doaj.org-article:4e92f6727d6149eaaf213ed39a6d3eb12021-12-02T20:16:31ZCardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.1932-620310.1371/journal.pone.0258622https://doaj.org/article/4e92f6727d6149eaaf213ed39a6d3eb12021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258622https://doaj.org/toc/1932-6203<h4>Background</h4>Chronic Chagas Cardiomyopathy (CCM) is a unique form of cardiomyopathy compared to other etiologies of heart failure. In CCM, risk prediction based on biomarkers has not been well-studied. We assessed the prognostic value of a biomarker panel to predict a composite outcome (CO), including the need for heart transplantation, use of left ventricular assist devices, and mortality.<h4>Methods</h4>Prospective cohort study of 100 adults with different stages of CCM. Serum concentrations of amino-terminal pro-B type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), high sensitivity troponin T (hs-cTnT), soluble (sST2), and cystatin-C (Cys-c) were measured. Survival analyses were performed using Cox proportional hazard models.<h4>Results</h4>During a median follow-up of 52 months, the mortality rate was 20%, while the CO was observed in 25% of the patients. Four biomarkers (NT-proBNP, hs-cTnT, sST2, and Cys-C) were associated with the CO; concentrations of NT-proBNP and hs-cTnT were associated with the highest AUC (85.1 and 85.8, respectively). Combining these two biomarkers above their selected cut-off values significantly increased risk for the CO (HR 3.18; 95%CI 1.31-7.79). No events were reported in the patients in whom the two biomarkers were under the cut-off values, and when both levels were above cut-off values, the CO was observed in 60.71%.<h4>Conclusion</h4>The combination of NT-proBNP and hs-TnT above their selected cut-off values is associated with a 3-fold increase in the risk of the composite outcome among CCM patients. The use of cardiac biomarkers may improve prognostic evaluation of patients with CCM.Luis E EcheverríaLyda Z RojasSergio Alejandro Gómez-OchoaOscar L Rueda-OchoaCristian David Sosa-VesgaTaulant MukaJames L JanuzziRachel MarcusCarlos A MorilloPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258622 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luis E Echeverría Lyda Z Rojas Sergio Alejandro Gómez-Ochoa Oscar L Rueda-Ochoa Cristian David Sosa-Vesga Taulant Muka James L Januzzi Rachel Marcus Carlos A Morillo Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.
description	<h4>Background</h4>Chronic Chagas Cardiomyopathy (CCM) is a unique form of cardiomyopathy compared to other etiologies of heart failure. In CCM, risk prediction based on biomarkers has not been well-studied. We assessed the prognostic value of a biomarker panel to predict a composite outcome (CO), including the need for heart transplantation, use of left ventricular assist devices, and mortality.<h4>Methods</h4>Prospective cohort study of 100 adults with different stages of CCM. Serum concentrations of amino-terminal pro-B type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), neutrophil gelatinase-associated lipocalin (NGAL), high sensitivity troponin T (hs-cTnT), soluble (sST2), and cystatin-C (Cys-c) were measured. Survival analyses were performed using Cox proportional hazard models.<h4>Results</h4>During a median follow-up of 52 months, the mortality rate was 20%, while the CO was observed in 25% of the patients. Four biomarkers (NT-proBNP, hs-cTnT, sST2, and Cys-C) were associated with the CO; concentrations of NT-proBNP and hs-cTnT were associated with the highest AUC (85.1 and 85.8, respectively). Combining these two biomarkers above their selected cut-off values significantly increased risk for the CO (HR 3.18; 95%CI 1.31-7.79). No events were reported in the patients in whom the two biomarkers were under the cut-off values, and when both levels were above cut-off values, the CO was observed in 60.71%.<h4>Conclusion</h4>The combination of NT-proBNP and hs-TnT above their selected cut-off values is associated with a 3-fold increase in the risk of the composite outcome among CCM patients. The use of cardiac biomarkers may improve prognostic evaluation of patients with CCM.
format	article
author	Luis E Echeverría Lyda Z Rojas Sergio Alejandro Gómez-Ochoa Oscar L Rueda-Ochoa Cristian David Sosa-Vesga Taulant Muka James L Januzzi Rachel Marcus Carlos A Morillo
author_facet	Luis E Echeverría Lyda Z Rojas Sergio Alejandro Gómez-Ochoa Oscar L Rueda-Ochoa Cristian David Sosa-Vesga Taulant Muka James L Januzzi Rachel Marcus Carlos A Morillo
author_sort	Luis E Echeverría
title	Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.
title_short	Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.
title_full	Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.
title_fullStr	Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.
title_full_unstemmed	Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.
title_sort	cardiovascular biomarkers as predictors of adverse outcomes in chronic chagas cardiomyopathy.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4e92f6727d6149eaaf213ed39a6d3eb1
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Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy.

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