Résumé :
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[BDSP. Notice produite par INIST-CNRS IG9CR0x7. Diffusion soumise à autorisation]. In this study, the authors aimed to investigate the prognostic value of bêta-type natriuretic peptide (BNP) for all-cause mortality among persons with Chagas disease, a parasitic disease caused by the protozoan Trypanosoma cruzi. The authors used data on 1,398 participants (37.5% infected with T. cruzi) aged 60 years and over from the Bambui Cohort Study of Aging in Brazil. From 1997 to 2007,512 participants died, leading to 12,406 person-years of observation. The hazard ratio for death was 1.27 for each unit of log-transformed BNP level (95% confidence interval (CI : 1.11,1.45) among infected persons, independent of potentially confounding factors. Infected persons with baseline BNP levels in the top quartile had a risk of death twice that of persons in the bottom quartile (hazard ratio=2.07,95% CI : 1.29,3.32). The discriminatory ability of BNP in predicting mortality (C=0.69,95% CI : 0.66,0.71) was similar to that of an electrocardiogram (C=0.68,95% CI : 0.65,0.71), with reasonably stable risk discrimination over time. BNP is a strong predictor of mortality in older adults with Chagas disease. Although the usefulness of BNP for risk stratification in this parasitic disease remains a topic of debate, this study found that BNP-based risk discrimination is at least comparable to that of an electrocardiogram.
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