Cardiovascular biomarkers as predictors of adverse outcomes in chronic Chagas cardiomyopathy

• Published in: PloS one Vol. 16; no. 10; p. e0258622
• Main Authors: Echeverría, Luis E, Rojas, Lyda Z, Gómez-Ochoa, Sergio Alejandro, Rueda-Ochoa, Oscar L, Sosa-Vesga, Cristian David, Muka, Taulant, Januzzi, James L, Marcus, Rachel, Morillo, Carlos A
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 28.10.2021; Public Library of Science (PLoS)
• Subjects: Analysis; Biological markers; Biology and Life Sciences; Biomarkers; Calcium-binding protein; Carbon monoxide; Cardiology; Cardiomyopathy; Cardiovascular disease; Chagas disease; Chronic illnesses; Congestive heart failure; Data collection; Diagnosis; Electrocardiography; Etiology; Galectin-3; Gelatinase; Health care; Health risks; Heart failure; Heart transplantation; Leukocytes (neutrophilic); Lipocalin; Medical prognosis; Medicine and Health Sciences; Mortality; Neutrophils; Peptides; Preventive medicine; Public health; Risk; Statistical models; Transplantation; Transplants & implants; Troponin; Troponin T; Vector-borne diseases; Ventricle; Ventricular assist devices; Colombia; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0258622

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. 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%. 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.