Chronic Chagas cardiopathy (CCC) is a potentially lethal condition, but the severity of the disease varies widely and accurate stratification of the risk of disease progression and death remains an unsolved challenge. Although complex prognostic scores are available, a simple, low-cost and easy-to-use prognostic model, suitable for the primary care setting, is lacking. The first hypothesis of this project is that a prognostic algorithm based on simple ECG measurements in conjunction with clinical information and Brain Natriuretic Peptide (BNP) levels can be developed that will accurately predict the risk of disease progression and death in CCC patients and be useful in clinical practice. The goal is therefore to develop and test a simple predictive algorithm for determining the prognosis of patients with CCC. To accomplish this goal, a large cohort of infected patients will be established based on the Telehealth Program designed to support primary care in Minas Gerais. We will enroll 2,000 CCC patients into this cohort study and follow them for at least two years, in order to develop and validate this simple prognostic algorithm. However we recognize that CCC has a complex physiopathology and many immunological, inflammatory, neural and microvascular processes have a role in development of CCC and progression of disease. The second hypothesis to be tested here is that hitherto unknown or untested biomarkers will be useful in the management of Chagas disease patients. The identification of new biomarkers through the other projects in the SAMI-Trop program should enable refined stratification of T cruzi infected patients with respect to occurrence of specific complications and death and in the guidance of treatment of CCC patients. Consequently, the second goal of this study is to collect blood specimens to establish a robust sample repository for testing of new biomarkers detected in the other branches of this project. The prognostic importance of these biomarkers will be tested using a nested case-control design

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Chronic Chagas cardiomyopathy (CCC) is the most important clinical presentation of Chagas disease. A simple prognostic algorithm will help primary care physicians manage and care for CCC patients. New biomarkers will also be evaluated for refined stratification of T cruzi infected patients for use in prognosis and guidance of treatment of CCC patients

National Institute of Health (NIH)
Specialized Center (P50)
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Special Emphasis Panel (ZAI1)
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Fundacao Faculdade de Medicina
Sao Paulo
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