{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:09:41Z","timestamp":1784876981281,"version":"3.55.0"},"reference-count":32,"publisher":"Sociedade Brasileira de Cardiologia","issue":"2","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A cardiomiopatia chag\u00e1sica cr\u00f4nica (CCC) \u00e9 a manifesta\u00e7\u00e3o mais grave da doen\u00e7a de Chagas e pode apresentar bradiarritmias que requerem implante de marca-passo (MP).  Objetivo  1. Identificar fatores contextuais associados \u00e0 implanta\u00e7\u00e3o de MP em indiv\u00edduos com CCC. 2. Avaliar o progn\u00f3stico (\u00f3bito) nesses grupos durante um per\u00edodo de acompanhamento de 4 anos.  M\u00e9todos  1. Estudo caso-controle aninhado na coorte SaMi-Trop. Os casos (pacientes com CCC que receberam implante de MP entre as ondas 1 e 2 do estudo) foram pareados com controles na propor\u00e7\u00e3o de 1:3, considerando equival\u00eancia quanto \u00e0 gravidade card\u00edaca basal. Foram consideradas vari\u00e1veis independentes relacionadas ao contexto municipal. Foi realizada regress\u00e3o log\u00edstica bin\u00e1ria. 2. An\u00e1lise de sobrevida para avaliar o progn\u00f3stico desses grupos, ajustada para vari\u00e1veis cl\u00ednicas (regress\u00e3o de Cox), considerando o \u00f3bito como desfecho. As conclus\u00f5es foram baseadas em um n\u00edvel de signific\u00e2ncia de 5%.  Resultados  O estudo incluiu 46 casos e 138 controles. As chances de implanta\u00e7\u00e3o de MP foram maiores entre indiv\u00edduos residentes em munic\u00edpios com: maior popula\u00e7\u00e3o (raz\u00e3o de chances [OR]: 3,6; intervalo de confian\u00e7a [IC] de 95%: 1,3 a 9,6), maior cobertura da Estrat\u00e9gia Sa\u00fade da Fam\u00edlia (OR: 5,3; IC 95%: 1,8 a 15,8) e menor n\u00famero de eletrocardi\u00f3grafos por mil habitantes (OR: 2,6; IC 95%: 1,0 a 6,6). Considerando 4 anos de seguimento, o \u00f3bito foi observado em 32,6% dos casos e 21,2% dos controles. Apenas a fra\u00e7\u00e3o de eje\u00e7\u00e3o afetou a sobrevida (risco relativo: 7,2; IC 95% 3,6 a 14,2).  Conclus\u00e3o  Fatores contextuais interferiram na implanta\u00e7\u00e3o de MP. No entanto, a implanta\u00e7\u00e3o de MP n\u00e3o influenciou o \u00f3bito durante os 4 anos de seguimento, o qual esteve associado apenas \u00e0 fra\u00e7\u00e3o de eje\u00e7\u00e3o.<\/jats:p>","DOI":"10.36660\/abc.20250003","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T16:40:46Z","timestamp":1775839246000},"source":"Crossref","is-referenced-by-count":2,"title":["Implanta\u00e7\u00e3o de Marca-passo em Pacientes com Doen\u00e7a de Chagas: Estudo Caso-Controle de Fatores Contextuais Associados e Progn\u00f3stico"],"prefix":"10.36660","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7381-2454","authenticated-orcid":false,"given":"S\u00e2mara Fernandes","family":"Leite","sequence":"first","affiliation":[{"name":"Universidade Estadual de Montes Claros,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8801-1828","authenticated-orcid":false,"given":"Maria Carmo Pereira","family":"Nunes","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3485-400X","authenticated-orcid":false,"given":"Cesar Augusto","family":"Taconeli","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9289-7014","authenticated-orcid":false,"given":"Mathaus Henrique Reis","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Montes Claros,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-3006","authenticated-orcid":false,"given":"Dardiane Santos","family":"Cruz","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Montes Claros,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7380-7548","authenticated-orcid":false,"given":"Lea Campos","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2623-5126","authenticated-orcid":false,"given":"Ester Cerdeira","family":"Sabino","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5185-5365","authenticated-orcid":false,"given":"Marco Paulo Tom\u00e1z","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2740-0042","authenticated-orcid":false,"given":"Antonio Luis Pinho","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2315-5318","authenticated-orcid":false,"given":"Ariela Mota","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Montes Claros,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0331-0747","authenticated-orcid":false,"given":"Desir\u00e9e Sant\u2019Ana","family":"Haikal","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Montes Claros,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22636","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","article-title":"Chagas Disease: From Discovery to a Worldwide Health Problem","volume":"7","author":"Lidani KCF","year":"2019","journal-title":"Front Public Health"},{"key":"ref2","series-title":"Ending the Neglect to Attain the Sustainable Development Goals A Road Map for Neglected Tropical Diseases 2021-2030","year":"2020"},{"key":"ref3","series-title":"Integrating Neglected Tropical Diseases Into Global Health and Development: Fourth WHO Report on Neglected Tropical Diseases","year":"2017"},{"key":"ref4","series-title":"Global Health Estimates 2016: Disease Burden by Cause, Age, Sex, by Country and by Region, 2000-2016","year":"2018"},{"key":"ref5","series-title":"Boletim Epidemiol\u00f3gico: Territorializa\u00e7\u00e3o e Vulnerabilidade para Doen\u00e7a de Chagas Cr\u00f4nica. 14 de abril - 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