Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study

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dc.contributor.authorBenchimol-Barbosa, P.R.
dc.contributor.authorTura, B.R.
dc.contributor.authorBarbosa, E.C.
dc.contributor.authorKantharia, B.K.
dc.date.accessioned2024-02-20T13:27:10Z
dc.date.available2024-02-20T13:27:10Z
dc.date.issued2013
dc.description.abstractThe SEARCH-RIO study prospectively investigated electrocardiogram (ECG)-derived variables in chronic Chagas disease (CCD) as predictors of cardiac death and new onset ventricular tachycardia (VT). Cardiac arrhythmia is a major cause of death in CCD, and electrical markers may play a significant role in risk stratification. One hundred clinically stable outpatients with CCD were enrolled in this study. They initially underwent a 12-lead resting ECG, signal-averaged ECG, and 24-h ambulatory ECG. Abnormal Q-waves, filtered QRS duration, intraventricular electrical transients (IVET), 24-h standard deviation of normal RR intervals (SDNN), and VT were assessed. Echocardiograms assessed left ventricular ejection fraction. Predictors of cardiac death and new onset VT were identified in a Cox proportional hazard model. During a mean follow-up of 95.3 months, 36 patients had adverse events: 22 new onset VT (mean±SD, 18.4±4/year) and 20 deaths (26.4±1.8/year). In multivariate analysis, only Q-wave (hazard ratio, HR=6.7; P<0.001), VT (HR=5.3; P<0.001), SDNN<100 ms (HR=4.0; P=0.006), and IVET+ (HR=3.0; P=0.04) were independent predictors of the composite endpoint of cardiac death and new onset VT. A prognostic score was developed by weighting points proportional to beta coefficients and summing-up: Q-wave=2; VT=2; SDNN<100 ms=1; IVET+ =1. Receiver operating characteristic curve analysis optimized the cutoff value at >1. In 10,000 bootstraps, the C-statistic of this novel score was non-inferior to a previously validated (Rassi) score (0.89±0.03 and 0.80±0.05, respectively; test for non-inferiority: P<0.001). In CCD, surface ECG-derived variables are predictors of cardiac death and new onset VT.
dc.identifier.citationBenchimol-Barbosa PR, Tura BR, Barbosa EC, Kantharia BK. Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study. Braz J Med Biol Res. 2013 Nov;46(11):974-984. doi: 10.1590/1414-431X20133141.
dc.identifier.otherDOI: 10.1590/1414-431X20133141
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/411
dc.language.isoen
dc.publisherBrazilian Journal of Medical and Biological Research
dc.subjectVentricular tachycardiaen
dc.subjectCardiac deathen
dc.subjectPrognostic scoreen
dc.subjectNoninvasive electrocardiographyen
dc.subjectChagas heart diseaseen
dc.titleUtility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study
dc.typeArticle
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