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Ischemic cerebrovascular events in patients with Chagas cardiomyopathy: a prospective follow-up study

Maria Carmo P Nunes1, Marcia M Barbosa, Antônio Luiz P Ribeiro

  • 1School of Medicine, Federal University of Minas Gerais, and ECOCENTER, Hospital Socor, Belo Horizonte, MG, Brazil. mcarmo@waymail.com.br

Journal of the Neurological Sciences
|January 24, 2009
PubMed

Insights

In Chagas cardiomyopathy patients, low left ventricular ejection fraction increases the risk of ischemic cerebrovascular events (ICE). This study identifies key predictors for ICE in this population.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Chagas disease cardiomyopathy is a prevalent form of dilated cardiomyopathy globally.
  • It is a significant cause of stroke in Latin America.
  • The long-term risk of ischemic cerebrovascular events (ICE) and its link to left ventricular (LV) dysfunction require further investigation.

Purpose of the Study:

  • To determine the incidence of ICE in patients with Chagas cardiomyopathy.
  • To evaluate the impact of LV ejection fraction on the risk of ICE.

Main Methods:

  • Prospective enrollment of 213 Chagas disease patients with LV systolic dysfunction.
  • Anticoagulation use was guided by clinical indications.
  • Cox proportional-hazards analysis was used to assess risk factors for ICE.

Main Results:

  • The overall incidence of ICE was 2.67 events per 100 patient-years over a mean follow-up of 36 months.
  • Independent risk factors for ICE included reduced LV ejection fraction (HR 0.95) and increased indexed left atrial volume (HR 1.04).
  • Patients with LV ejection fraction ≤35% had a 3.41-fold increased risk of ICE.

Conclusions:

  • The annual incidence of ICE in Chagas cardiomyopathy patients is relatively low.
  • LV ejection fraction and indexed left atrial volume are independently associated with ICE risk in this cohort.
Abstract

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