A risk score for predicting death in Chagas' heart disease.

VIOTTI R; VIGLIANO CA; ARMENTI A

NEW ENGLAND JOURNAL OF MEDICINE

MASSACHUSETTS MEDICAL SOC

Año: 2006 vol. 355 p. 2489 - 2489

0028-4793

In the study by Rassi et al., the percentage of patients treated with amiodarone was high, whereas the percentage treated with angiotensin-converting enzyme (ACE) inhibitors or beta-blockers was low. ACE inhibitors have a known effect on the prognosis of these patients. Furthermore, the exclusion of patients over 70 years of age who had sustained ventricular tachycardia or pacemakers is not justified, in our opinion, for the predictive analysis of the risk of death. Finally, the multivariate analysis excluded some measures of left ventricular function derived from the echocardiogram. Only one such variable, segmental or global wall-motion abnormality, was included. Systolic function is an important predictor of the risk of death, as illustrated in a previous score of risk derived from a cohort of 856 patients. The results of the Cox model and the score could have changed substantially with the inclusion of left ventricular ejection fraction or other measures of systolic function.