Banca de QUALIFICAÇÃO: MOISÉS WESLEY DE MACÊDO PEREIRA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : MOISÉS WESLEY DE MACÊDO PEREIRA
DATE: 02/06/2025
TIME: 14:30
LOCAL: Auditório da Pós-Graduação da Faculdade de Medicina
TITLE:

: Assessment of predictive biomarkers of chagas disease reactivation in heart transplant recipientes

KEY WORDS:

Chagas Disease; Heart Transplantation; Health Profile; Biomarkers

PAGES: 50
BIG AREA: Ciências Biológicas
AREA: Bioquímica
SUMMARY:

Introduction: Chagas disease (CD) remains a leading cause of heart failure in Brazil, particularly affecting individuals in situations of social vulnerability. In advanced stages, heart transplantation is the main therapeutic option; however, the required immunosuppression increases the risk of Trypanosoma cruzi reactivation. Although this complication is clinically relevant, few studies have compared the clinical profiles and outcomes of patients with CD to those with other cardiomyopathies undergoing transplantation. Objective: To evaluate predictive biomarkers of Chagas disease reactivation in heart transplant recipients. Materials and Methods: This retrospective study included 326 patients who underwent heart transplantation between 2007 and 2023 at a public reference center in the Federal District of Brazil. A total of 201 patients had CD and 125 had other etiologies (idiopathic, ischemic, dilated, or other). Sociodemographic variables, comorbidities, and causes of death were analyzed using chi-square tests, Fisher’s exact test, Monte Carlo simulations (50,000 replications), and logistic regression, with a 5% significance level. Results and discussion: CD was more prevalent among adult males with brown skin, low educational attainment, manual labor occupations, and origins in historically endemic states (Bahia, Goiás, and Minas Gerais). Other cardiomyopathy types displayed distinct patterns: ischemic cardiomyopathy was significantly associated with older males with histories of myocardial infarction and dyslipidemia; idiopathic cardiomyopathy was associated with obesity, stroke/TIA, and alcohol use; and the dilated type was associated with post-transplant diabetes. Reactivation occurred in 31.8% of CD patients and was significantly associated with the 40–59 age group, brown skin color, stroke/TIA history, and post-transplant type 2 diabetes. Despite the severity of the condition, the reactivation group had a lower mortality rate (26.6% vs. 50.4%), possibly due to early diagnosis and clinical intervention. Of the 131 recorded deaths, 86 occurred in the CD group (65.6%), with significant associations with infectious and cardiovascular causes. Other cardiomyopathy groups had lower mortality rates and more varied causes of death. Conclusion: Chagas cardiomyopathy was characterized by a more vulnerable clinical and social profile, a higher incidence of reactivation, and a greater concentration of deaths compared to other etiologies. These findings underscore the need for specific strategies to monitor and manage this population, taking into account not only clinical aspects but also the social determinants of health that directly influence post-transplant outcomes

COMMITTEE MEMBERS:
Externa à Instituição - ALINE DE OLIVEIRA COSTA - ESCS
Externa ao Programa - 2446211 - NADJAR NITZ SILVA LOCIKS DE ARAUJO - nullExterno ao Programa - 3343228 - RODRIGO GURGEL GONCALVES - nullExterna à Instituição - TAMIRES EMANUELE VITAL - UNYLEYA