Prevalence and Impact of Chagas Disease Among Latin American Immigrants With Nonischemic Cardiomyopathy in Los Angeles, California. (September 2015)

• Record Type: Journal Article
• Authors: Traina, Mahmoud I.; Sanchez, Daniel R.; Hernandez, Salvador; Bradfield, Jason S.; Labedi, Mohamed R.; Ngab, Tarik A.; Steurer, Frank; Montgomery, Susan P.; Meymandi, Sheba K.
• Is Part Of: Circulation. Volume 8:Number 5(2015)
• Publication Date: 2015-09
• Subjects: Heart failure -- Periodicals; 616.129005
• DOI: 10.1161/CIRCHEARTFAILURE.115.002229
• Languages: English
• ISSNs: 1941-3289

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background—</title> <p>Chagas disease is a well-known cause of cardiomyopathy in Latin America; however, 300 000 individuals are estimated to have Chagas disease in the United States. This study examined the prevalence and impact of Chagas cardiomyopathy (CCM) in a US population. We hypothesized that patients with CCM would have increased morbidity and mortality when compared with patients with non-CCM.</p> </sec> <sec> <title>Methods and Results—</title> <p>This is a single-center, prospective cohort study. Enrollment criteria were new diagnosis of nonischemic cardiomyopathy (left ventricular ejection fraction ⩽40%) and previous residence in Latin America for at least 12 months. Serological testing for <italic>Trypanosoma cruzi</italic> was performed at enrollment. The primary end point was all-cause mortality or heart transplantation. The secondary end point was heart failure–related hospitalization. A total of 135 patients were enrolled, with a median of 43 months of follow-up. Chagas disease was diagnosed in 25 (19%) patients. The primary end point occurred in 9 patients (36%) in the CCM group and in 11 patients (10%) in the non-CCM group (hazard ratio [HR], 4.46; 95% confidence interval, 1.8–10.8; <italic>P</italic>=0.001). The secondary end point occurred in 13 patients (52%) in the CCM group and in 35 patients (32%) in the non-CCM group (HR, 2.22; 95% confidence interval, 1.2–4.2; <italic>P</italic>=0.01).</p> </sec> <sec> <title>Conclusions—</title> <p>There is a high prevalence of Chagas disease among Latin American immigrants diagnosed with nonischemic cardiomyopathy in Los Angeles. Advanced CCM portends a poor prognosis and is associated with increased all-cause mortality/heart transplantation and heart failure–related hospitalization.</p> </sec> </abstract>