Abstract 16277: B-type Natriuretic Predicts 10-year Stroke Mortality in Community-Dwelling Elderly with Chagas Disease (the Bambuíi Study)
Background and purpose: Previous case-control studies have suggested a causal link between Chagas disease (ChD), which is caused by the protozoan Trypanosoma cruzi, and stroke. We investigated the relationship between ChD and long-term stroke mortality in a large community-based cohort of older adults.
Methods: Participants were 1,398 (80.3% from total) residents aged 60 and over in Bambuíi City, Brazil. The endpoint was death from stroke. Potential confounding variables included age, sex, conventional risk factors and high sensitive C reactive protein.
Results: Participants of this study were followed from 1997 to 2007, leading to 9,740 person-years (pyrs) of observation. The baseline prevalence of T. cruzi infection was 37.5% and the overall mortality rate from stroke was 4.62 per 1,000 pyrs. The risk of death from stroke among T. cruzi infected participants was twice that of those noninfected (Adjusted hazard ratio (HR) = 2.36; 95% CI 1.25, 4.44). A BNP level in the top quartile was a strong and independent predictor of stroke mortality among those infected (Adjusted HR = 2.72; 95% CI 1.25, 5.91). The presence of both a high BNP level and atrial fibrillation on ECG increased the risk of stroke mortality by 11.49 (95% CI 3.19, 41.38) in these individuals (table).
Conclusions: This study provides new evidence supporting a causal link between ChD and stroke. The results also showed for the first time that BNP alone, or in association with atrial fibrillation, has prognostic value for stroke mortality in T. cruzi chronically infected older adults.
- © 2010 by American Heart Association, Inc.