TY - JOUR T1 - Additional value of anaerobic threshold in a general mortality prediction model in a urban patient cohort with Chagas cardiomyopathy JO - Revista Portuguesa de Cardiologia (English edition) T2 - AU - Silva,Roberto Ribeiro da AU - Reis,Michel Silva AU - Pereira,Basílio de Bragança AU - Nascimento,Emilia Matos do AU - Pedrosa,Roberto Coury SN - 21742049 M3 - 10.1016/j.repce.2017.06.009 DO - 10.1016/j.repce.2017.06.009 UR - https://www.revportcardiol.org/en-additional-value-anaerobic-threshold-in-articulo-S2174204917303586 AB - IntroductionThe anaerobic threshold (AT) is an objective and direct measurement that reflects variations in metabolism of skeletal muscles during exercise. Its prognostic value in heart disease of non-Chagas etiology is well established. The risk of mortality in Chagas cardiomyopathy is relatively well assessed by the Rassi score. However, the added value that AT can bring to the Rassi score has not been studied. ObjectiveTo assess whether AT presents additional prognostic value to the Rassi score in patients with chronic Chagas cardiomyopathy. MethodsIn this prospective dynamic cohort study, 150 medical records were reviewed, and 45 records of patients who underwent cardiopulmonary exercise testing between 1996 and 1997 and followed until September 2015 were selected. The data were analyzed using a logistic regression model to detect associations between the study variables. The fit of the models was confirmed using receiver operating curves and the coefficient of determination R2. ResultsEight patients (17.78%) had died by September 2015, seven of them (87.5%) from cardiovascular causes, of whom four (57.14%) were considered high risk by the Rassi score. With the Rassi score as independent variable and death as the outcome, we obtained an area under the curve (AUC) of 0.711, with R2=0.214. With AT as independent variable, AUC was 0.706, with R2=0.078. When both Rassi score and AT were defined as independent variables, AUC was 0.800, with R2=0.263. ConclusionWhen AT is included in logistic regression, it increases the accuracy of the Rassi score for mortality prediction by 5%. ER -