Circulation: Heart Failure
Volume 8, Issue 5, 2015, Pages 938-943

Prevalence and Impact of Chagas Disease among Latin American Immigrants with Nonischemic Cardiomyopathy in Los Angeles, California (Article) (Open Access)

Traina M.I.* , Sanchez D.R. , Hernandez S. , Bradfield J.S. , Labedi M.R. , Ngab T.A. , Steurer F. , Montgomery S.P. , Meymandi S.K.
  • a Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States
  • b Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States
  • c Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States
  • d Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States, UCLA, Cardiac Arrhythmia Center, Ronald Reagan UCLA, Los Angeles, CA, United States
  • e Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States
  • f Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States
  • g Centers for Disease Control and Prevention, Atlanta, GA, United States
  • h Centers for Disease Control and Prevention, Atlanta, GA, United States
  • i Center of Excellence for Chagas Disease, David Geffen School of Medicine, UCLA, 14445 Olive View Dr, Sylmar, CA 91342, United States

Abstract

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. Methods and Results-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 Trypanosoma cruzi 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; P=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; P=0.01). Conclusions-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. © 2015 American Heart Association, Inc.

Author Keywords

Chagas cardiomyopathy Cardiomyopathies Prognosis Heart failure Mortality

Index Keywords

prospective study immigrant South and Central America hospitalization Latin America beta adrenergic receptor blocking agent Follow-Up Studies follow up Prospective Studies human epidemiology middle aged controlled study priority journal Aged ethnology United States Humans migrant California male Emigrants and Immigrants female prevalence Article cardiac patient hydroxymethylglutaryl coenzyme A reductase inhibitor dipeptidyl carboxypeptidase inhibitor major clinical study adult serology cardiovascular mortality cohort analysis Heart Transplantation Chagas Disease amiodarone implantable cardioverter defibrillator Cardiomyopathies aldosterone antagonist angiotensin receptor antagonist heart left ventricle ejection fraction cardiomyopathy heart failure nonischemic cardiomyopathy
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84953343773&doi=10.1161%2fCIRCHEARTFAILURE.115.002229&partnerID=40&md5=c5e1de4e38872c4a346c5dc2440fa49f
DOI: 10.1161/CIRCHEARTFAILURE.115.002229
ISSN: 19413289
Cited by: 21
Original Language: English