Longitudinal study of patients with chronic Chagas cardiomyopathy in Brazil (SaMi-Trop project): a cohort profile.
Longitudinal study of patients with chronic Chagas cardiomyopathy in Brazil (SaMi-Trop project): a cohort profile.
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DOI：
10.1136/bmjopen-2016-011181
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发表时间：
2016-05-04
期刊：
影响因子：
2.9
通讯作者：
Ribeiro AL
中科院分区：
文献类型：
--
作者：
Cardoso CS;Sabino EC;Oliveira CD;de Oliveira LC;Ferreira AM;Cunha-Neto E;Bierrenbach AL;Ferreira JE;Haikal DS;Reingold AL;Ribeiro AL
我们已经建立了一个前瞻性队列的1959例慢性查加斯心肌病患者，以评估是否临床预测规则的基础上心电图，脑钠肽（BNP）水平，和其他生物标志物可以在临床实践中是有用的。本文概述了参与者的研究和基线特征。这项研究正在巴西米纳斯吉拉斯州北方的21个城市进行，包括2年的随访。 基线评价包括收集社会人口信息、健康的社会决定因素、与健康有关的行为、合并症、正在使用的药物、既往恰加斯病治疗史、功能分类、生活质量、血样采集和心电图。患者多为女性，年龄50-74岁，家庭收入低，文化程度低，已知查加斯病>10年; 46%功能分级>II级。 25.2%的患者报告既往使用过苄硝唑，6.2%的患者报告永久使用过起搏器。几乎一半的患者出现高胆固醇和高血压，其中三分之一患有糖尿病。在30%的样品中，激素原BNP的N-末端（NT-ProBNP）水平>300 pg/mL。预测严重和进行性查加斯病的临床和实验室标志物被确定为高NT-ProBNP水平以及晚期心力衰竭的症状。这些结果证实了偏远地区南美锥虫病的重要残留发病率，从而支持了在未来几年除了流行病学监测外还应优先考虑慢性南美锥虫病心肌病的医疗的政治决定。圣保罗-米纳斯吉拉斯热带医学研究中心（SaMi-Trop）代表了重点研究被忽视疾病的重大挑战，其知识可应用于初级保健。我们将继续跟踪这一患者队列，以提供有关在社会和经济不平等的偏远地区恰加斯病发展和进展的相关信息。NCT 02646943;预结果。
We have established a prospective cohort of 1959 patients with chronic Chagas cardiomyopathy to evaluate if a clinical prediction rule based on ECG, brain natriuretic peptide (BNP) levels, and other biomarkers can be useful in clinical practice. This paper outlines the study and baseline characteristics of the participants. The study is being conducted in 21 municipalities of the northern part of Minas Gerais State in Brazil, and includes a follow-up of 2 years. The baseline evaluation included collection of sociodemographic information, social determinants of health, health-related behaviours, comorbidities, medicines in use, history of previous treatment for Chagas disease, functional class, quality of life, blood sample collection, and ECG. Patients were mostly female, aged 50–74 years, with low family income and educational level, with known Chagas disease for >10 years; 46% presented with functional class >II. Previous use of benznidazole was reported by 25.2% and permanent use of pacemaker by 6.2%. Almost half of the patients presented with high blood cholesterol and hypertension, and one-third of them had diabetes mellitus. N-terminal of the prohormone BNP (NT-ProBNP) level was >300 pg/mL in 30% of the sample. Clinical and laboratory markers predictive of severe and progressive Chagas disease were identified as high NT-ProBNP levels, as well as symptoms of advanced heart failure. These results confirm the important residual morbidity of Chagas disease in the remote areas, thus supporting political decisions that should prioritise in addition to epidemiological surveillance the medical treatment of chronic Chagas cardiomyopathy in the coming years. The São Paulo-Minas Gerais Tropical Medicine Research Center (SaMi-Trop) represents a major challenge for focused research in neglected diseases, with knowledge that can be applied in primary healthcare. We will continue following this patients’ cohort to provide relevant information about the development and progression of Chagas disease in remotes areas, with social and economic inequalities. NCT02646943; Pre-results.