Anos de vida perdidos ajustados por incapacidade (do inglês, Disability-Adjusted Life-Year)

FILHO, M.M., ET AL.: Probability of Occurrence of Life-Threatening Ventricular Arrhythmias in Chagas' Disease versus Non-Chagas' Disease. The implantable cardioverter defibrillator (ICD) is highly effective in the treatment of ventricular arrhythmias (VA) responsible for sudden cardiac death. However, the prob ability of occurrence of these arrhythmic events in presence of cardiomyopathy remains uncertain. The aim of this study was to compare the probability of nonoccurrence of life-threatening VA in ICD recipients with Chagas' versus non-Chagas' heart disease. Over a mean follow-up of 10.5 months, 53 ICD recipients (mean age = 50.1 years, 48 male) were evaluated. Eleven patients had Chagas' heart disease, 19 had idiopathic dilated cardiomyopathy and 23 had ischémie cardiomyopathy. Ventricular tachyarrhythmias with a cycle length < 315 ms were considered life-threatening. The cumulative probability of nonoccur rence of life-threatening VA was examined by Kaplan-Meyer method and the outcomes were submitted to the log rank test. At 2 years, the cumulative probability of life-threatening VA nonoccurrence was 0 in the Chagas' heart disease group versus 40% up to 55 months of follow-up in the non-Chagas' disease group (P = 0.0097). Among patients with cardiomyopathies of different etiologies, those with Chagas' heart dis ease had the lowest cumulative probability of nonoccurrence of life-threatening VA, confirming its unfa vorable prognosis and the importance of preventive measures against sudden death in this disease. (PACE 2000; 23[Pt. II]:1944-1946 Chagas' heart disease, sudden death, implantable cardioverter defibrillator

The Modified Higgins PI showed to be superior to the Parsonnet PI at the surgical risk stratification, showing the importance of the analysis of intraoperative events and physiological variables at the patient's ICU admission, when prognostic definition is achieved.

No abstract

Background Acute heart failure (HF) is an important complication of coronavirus disease 2019 (COVID-19) and has been hypothesized to relate to inflammatory activation. Methods We evaluated consecutive intensive care unit (ICU) admissions for COVID-19 across 6 centers in the Critical Care Cardiology Trials Network, identifying patients with vs. without acute HF. Acute HF was sub-classified as " de novo " vs. "acute-on-chronic" based on the absence or presence of prior HF. Clinical features, biomarker profiles, and outcomes were compared. Results Among 901 COVID-19 ICU admissions, 80 (8.9%) had acute HF, including 18 (2.0%) with classic cardiogenic shock (CS) and 37 (4.1%) with vasodilatory CS. The majority (n=45) were de novo HF presentations. Compared to patients without acute HF, those with acute HF had higher cardiac troponin (cTn) and natriuretic peptides, and similar inflammatory biomarkers; patients with de novo HF had the highest cTn. Notably, among critically ill patients with COVID-19, illness severity (median SOFA, 8 [IQR, 5-10] vs. 6 [ 4 -9]; p=0.025) and mortality (43.8% vs. 32.4%; p=0.040) were modestly higher in patients with vs. without acute HF. Conclusions Among critically ill COVID-19 patients, acute HF is distinguished more by biomarkers of myocardial injury and hemodynamic stress than by biomarkers of inflammation.