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Chagas disease: independent risk factor for stroke
Leonardo C Paixão1, Antonio L Ribeiro, Reginaldo A Valacio
1Odilon Behrens Hospital, Federal University of Minas Gerais Faculdade de Medicina, Belo Horizonte, Brazil. leonardopaixao@yahoo.com.br
Stroke
|October 17, 2009
Summary
Chagas disease (CD) is an independent risk factor for ischemic stroke. This study suggests considering CD in patients from endemic areas presenting with stroke symptoms.
Area of Science:
- Cardiology
- Neurology
- Infectious Diseases
Background:
- Chagas disease (CD) cardiomyopathy is a suspected risk factor for cerebrovascular events.
- Evidence linking CD to stroke is limited, with proposed cardioembolic and inflammatory mechanisms.
- Previous studies often lacked adequate control groups for comparison.
Purpose of the Study:
- To determine if Chagas disease (CD) is an independent risk factor for ischemic stroke.
- To compare stroke patients with acute coronary syndrome patients with similar cardiovascular risk profiles.
- To investigate the association between CD serology and stroke incidence.
Main Methods:
- A case-control study involving 101 ischemic stroke patients and 100 acute coronary syndrome patients.
- Chagas disease (CD) diagnosis confirmed by positive immunofluorescence and hemagglutination tests.
- Analysis of clinical, laboratory, and electrocardiogram (ECG) findings.
Main Results:
- CD-positive serology was significantly more frequent in stroke patients (P=0.002).
- Independent predictors of stroke included prior stroke/TIA (OR=6.98), atrial fibrillation (OR=4.52), and CD-positive serology (OR=7.17).
- Age, female sex, and blood pressure were also associated with stroke in univariate analysis.
Conclusions:
- Chagas disease (CD) appears to be an independent risk factor for ischemic stroke.
- CD should be considered a potential etiological factor in stroke patients from endemic regions.
- Further research may elucidate specific mechanisms linking CD to cerebrovascular events.
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