SURVIVAL AND PREDICTORS OF SURVIVAL IN PATIENTS WITH CONGESTIVE-HEART-FAILURE DUE TO CHAGAS CARDIOMYOPATHY

Background The fundamental determinant of the natural history of Chaga s' disease is cardiac involvement. Methods and Results We studied 104 male patients with congestive heart failure due to Chagas' disease to estimate the survival distribution function and to evaluate age, funct ional class (FC), maximal oxygen consumption (Vo(2)max), and ejection fraction (EF) as predictors of survival. Statistical evaluation was pe rformed through univariate (Student's t test and chi(2) test) and mult ivariate analyses (Cox's regression model). Overall survival was 66% a t 1 year, 56% at 3 years, and 48% at 5 years. Ages were not statistica lly different (P=.9811) between survivor (40.3+/-8.7) and nonsurvivor (40.3+/-9.4) groups. The ejection fraction(s) were statistically diffe rent (P=.0001) between survival (43.6+/-9.9) and nonsurvival (30.6+/-8 .1) groups, as was Vo(2)max (P=.0001) (21.0+/-4.7 and 15.0+/-4.9, resp ectively). Most of the surviving patients were in FC II and most of th e nonsurvivors were in FC IV (P=.0001). Vo(2)max (P=.0001) and EF (P=. 0008) are highly associated with survival time in the multivariate ana lysis, but FC (P=.0578) is less important. Age (P=.9811) did not influ ence survival. Conclusions We conclude that 50% of the patients with h eart failure due to Chagas' disease die in 47 months and that Vo(2)max and EF are important indices of survival in this group.