Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.

American trypanosomiasis (Chagas disease, CD) affects circa 7 million persons worldwide. While of those persons present the asymptomatic, indeterminate chronic form (ICF), many will eventually progress to cardiac or digestive disorders. We studied a nonconcurrent (retrospective) cohort of patients a...

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Autores principales:	Erika Alessandra Pellison Nunes da Costa, Cassiano Victória, Carlos Magno Castelo Branco Fortaleza
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/f5a610526bac404c9f9fd9d4f1c5ed33
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spelling	oai:doaj.org-article:f5a610526bac404c9f9fd9d4f1c5ed332021-12-02T20:24:18ZPredictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.1935-27271935-273510.1371/journal.pntd.0009680https://doaj.org/article/f5a610526bac404c9f9fd9d4f1c5ed332021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009680https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735American trypanosomiasis (Chagas disease, CD) affects circa 7 million persons worldwide. While of those persons present the asymptomatic, indeterminate chronic form (ICF), many will eventually progress to cardiac or digestive disorders. We studied a nonconcurrent (retrospective) cohort of patients attending an outpatient CD clinic in Southeastern Brazil, who were admitted while presenting the ICF in the period from 1998 through 2018 and followed until 2019. The outcomes of interest were the progression to cardiac or digestive CD forms. We were also interested in analyzing the impact of Benznidazole therapy on the progression of the disease. Extensive review of medical charts and laboratory files was conducted, collecting data up to year 2019. Demographics (upon inclusion), body mass index, comorbidities (including the Charlson index) and use of Benznidazole were recorded. The outcomes were defined by abnormalities in those test that could not be attributed to other causes. Statistical analysis included univariate and multivariable Cox regression models. Among 379 subjects included in the study, 87 (22.9%) and 100 (26.4%) progressed to cardiac and digestive forms, respectively. In the final multivariable model, cardiac disorders were positively associated with previous coronary syndrome (Hazzard Ratio [HR], 2.42; 95% Confidence Interval [CI], 1.53-3.81) and negatively associated with Benznidazole therapy (HR, 0.26; 95%CI, 0.11-0.60). On the other hand, female gender was the only independent predictor of progression to digestive forms (HR, 1.56; 95%CI, 1.03-2.38). Our results point to the impact of comorbidities on progression do cardiac CD, with possible benefit of the use of Benznidazole.Erika Alessandra Pellison Nunes da CostaCassiano VictóriaCarlos Magno Castelo Branco FortalezaPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 8, p e0009680 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Erika Alessandra Pellison Nunes da Costa Cassiano Victória Carlos Magno Castelo Branco Fortaleza Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.
description	American trypanosomiasis (Chagas disease, CD) affects circa 7 million persons worldwide. While of those persons present the asymptomatic, indeterminate chronic form (ICF), many will eventually progress to cardiac or digestive disorders. We studied a nonconcurrent (retrospective) cohort of patients attending an outpatient CD clinic in Southeastern Brazil, who were admitted while presenting the ICF in the period from 1998 through 2018 and followed until 2019. The outcomes of interest were the progression to cardiac or digestive CD forms. We were also interested in analyzing the impact of Benznidazole therapy on the progression of the disease. Extensive review of medical charts and laboratory files was conducted, collecting data up to year 2019. Demographics (upon inclusion), body mass index, comorbidities (including the Charlson index) and use of Benznidazole were recorded. The outcomes were defined by abnormalities in those test that could not be attributed to other causes. Statistical analysis included univariate and multivariable Cox regression models. Among 379 subjects included in the study, 87 (22.9%) and 100 (26.4%) progressed to cardiac and digestive forms, respectively. In the final multivariable model, cardiac disorders were positively associated with previous coronary syndrome (Hazzard Ratio [HR], 2.42; 95% Confidence Interval [CI], 1.53-3.81) and negatively associated with Benznidazole therapy (HR, 0.26; 95%CI, 0.11-0.60). On the other hand, female gender was the only independent predictor of progression to digestive forms (HR, 1.56; 95%CI, 1.03-2.38). Our results point to the impact of comorbidities on progression do cardiac CD, with possible benefit of the use of Benznidazole.
format	article
author	Erika Alessandra Pellison Nunes da Costa Cassiano Victória Carlos Magno Castelo Branco Fortaleza
author_facet	Erika Alessandra Pellison Nunes da Costa Cassiano Victória Carlos Magno Castelo Branco Fortaleza
author_sort	Erika Alessandra Pellison Nunes da Costa
title	Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.
title_short	Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.
title_full	Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.
title_fullStr	Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.
title_full_unstemmed	Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.
title_sort	predictors of development of cardiac and digestive disorders among patients with indeterminate chronic chagas disease.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f5a610526bac404c9f9fd9d4f1c5ed33
work_keys_str_mv	AT erikaalessandrapellisonnunesdacosta predictorsofdevelopmentofcardiacanddigestivedisordersamongpatientswithindeterminatechronicchagasdisease AT cassianovictoria predictorsofdevelopmentofcardiacanddigestivedisordersamongpatientswithindeterminatechronicchagasdisease AT carlosmagnocastelobrancofortaleza predictorsofdevelopmentofcardiacanddigestivedisordersamongpatientswithindeterminatechronicchagasdisease
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Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease.

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