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Cardiovascular medicine
Cohort profile
Longitudinal study of patients with chronic Chagas cardiomyopathy in Brazil (SaMi-Trop project): a cohort profile
  1. Clareci Silva Cardoso1,2,
  2. Ester Cerdeira Sabino3,
  3. Claudia Di Lorenzo Oliveira1,
  4. Lea Campos de Oliveira4,
  5. Ariela Mota Ferreira5,
  6. Edécio Cunha-Neto6,7,8,
  7. Ana Luiza Bierrenbach3,
  8. João Eduardo Ferreira9,
  9. Desirée Sant'Ana Haikal5,
  10. Arthur L Reingold2,
  11. Antonio Luiz P Ribeiro10
  1. 1Federal University of São João del-Rei, Brazil
  2. 2University of California, Berkeley, California, USA
  3. 3Department of Infectious Diseases, School of Medicine and Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
  4. 4Laboratory of Medicine Laboratorial (LIM03), General Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil
  5. 5Health Science Programme, State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
  6. 6Laboratory of Immunology, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
  7. 7Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
  8. 8Institute for Investigation in Immunology, iii-INCT, São Paulo, Brazil
  9. 9Institute of Mathematics and Statistics (IME), University of São Paulo, São Paulo, Brazil
  10. 10Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  1. Correspondence to Professor Clareci Silva Cardoso; clarecicardoso{at}yahoo.com.br

Abstract

Purpose 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.

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.

Findings to date 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.

Future plans 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.

Trial registration number NCT02646943; Pre-results.

  • Chagas disease
  • Cohort Studies
  • Biomarkers
  • CHEMICAL PATHOLOGY

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjopen-2016-011181

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