Plasma b-Type Natriuretic Peptide As a Predictor of Mortality in Community-Dwelling Older Adults With Chagas Disease: 10-Year Follow-up of the Bambuı´ Cohort Study of Aging

• Maria Fernanda Lima-Costa ^[1] ; Cibele C. Cesa
  1. [1] Laborato´rio de Epidemiologia e Antropologia Médica
• Localización: American journal of epidemiology, ISSN-e 1476-6256, ISSN 0002-9262, Vol. 172, Nº. 2, 2010, págs. 190-196
• Idioma: inglés
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• Resumen

  • In this study, the authors aimed to investigate the prognostic value of b-type natriuretic peptide (BNP) for allcause mortality among persons with Chagas disease, a parasitic disease caused by the protozoan 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 (C ¼ 0.69, 95% CI:0.66, 0.71) was similar to that of an electrocardiogram (C ¼ 0.68, 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.