A Risk Score for Predicting Death in Chagas' Heart Disease

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Abstract
Rassi et al. (Aug. 24 issue)1 developed a risk score to predict death in Chagas' disease. They used data obtained by clinical examination and routine noninvasive tests. We analyzed our own data in order to evaluate the performance of the risk score in an independent sample. In a cohort of 183 patients with Chagas' disease and without other cardiopathies or diseases, we followed 158 patients for 5 years or more at the Federal University of Minas Gerais, in Belo Horizonte, Brazil. All patients were evaluated by means of clinical examination, electrocardiography, chest radiography, echocardiography, Holter monitoring, and exercise testing. They were classified (according to the risk score) as low-, intermediate-, or high-risk patients, and their vital status at 5 years was assessed. Although our cohort differs from that of Rassi et al., including a smaller proportion of high-risk patients, the observed 5-year risk of death for each risk stratum in the two cohorts was similar ( Table 1 ). The score that Rassi et al. developed was a powerful predictive tool in our sample and may be valuable in clinical practice for stratifying the risk of death among patients with Chagas' disease.