Abstract 18171: Chagasic Cardiomyopathy is Associated with Increased Morbidity and Mortality Compared to Nonischemic Cardiomyopathy Among Latin American Immigrants Living in Los Angeles
Background: Chagas disease is the leading cause of cardiomyopathy in Latin America and Los Angeles County has more than 2 million residents born in Chagas-endemic countries. There are no data on the prevalence, morbidity, and mortality of Chagasic cardiomyopathy in a US-based population.
Methods: We prospectively enrolled 135 patients from a Los Angeles County hospital who were diagnosed with nonischemic cardiomyopathy (ejection fraction <40%) and previously resided in Latin America for at least 12 months. Serologic testing for Chagas disease was performed at enrollment. The primary endpoint was all-cause mortality or cardiac transplant. The secondary endpoint was heart failure-related hospitalization.
Results: Median length of follow-up was 3.6 years. Chagas disease was diagnosed in 25 (19%) patients. Baseline characteristics between the Chagas and non-Chagas groups were similar. At 4 years, the estimated survival rate was 54.1% (CI, 30.4 to 77.8%) for the Chagas group and 88.3% (CI, 81.6 to 95.0%) for the non-Chagas group (p < 0.001). The crude mortality/cardiac transplant rate per 100 person-years of follow-up was 13.4% (CI, 5.3 to 21.6%) for the Chagas group and 2.9% (CI, 1.2 to 4.5%) for the non-Chagas group (p < 0.05). At 4 years, the estimated percent free from heart failure-related hospitalization was 34.8% (CI, 11.3 to 58.3%) for the Chagas group and 63.1% (CI, 52.9 to 73.3%) for the non-Chagas group (p = 0.01). The crude heart failure-related hospitalization rate per 100 person-years of follow-up was 50.5% (CI, 36.8 to 64.2%) for the Chagas group and 23.5% (18.9 to 28.1%) for the non-Chagas group (p < 0.01).
Conclusions: Chagasic cardiomyopathy is a common cause of nonischemic cardiomyopathy among Latin American immigrants living in Los Angeles, California. Compared to nonischemic cardiomyopathy, Chagasic cardiomyopathy portends a poor prognosis and is associated with significantly increased all-cause mortality or need for cardiac transplant and heart failure-related hospitalizations.
- © 2012 by American Heart Association, Inc.