201. Ten-Year Incidence of Chagas Cardiomyopathy Among Asymptomatic Trypanosoma cruzi–Seropositive Former Blood Donors
- Author
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Sabino, Ester C, Ribeiro, Antonio L, Salemi, Vera MC, Di Lorenzo Oliveira, Claudia, Antunes, Andre P, Menezes, Marcia M, Ianni, Barbara M, Nastari, Luciano, Fernandes, Fabio, Patavino, Giuseppina M, Sachdev, Vandana, Capuani, Ligia, de Almeida-Neto, Cesar, Carrick, Danielle M, Wright, David, Kavounis, Katherine, Goncalez, Thelma T, Carneiro-Proietti, Anna Barbara, Custer, Brian, Busch, Michael P, and Murphy, Edward L
- Subjects
Cardiovascular ,Clinical Research ,Rare Diseases ,Vector-Borne Diseases ,Infectious Diseases ,Heart Disease ,Good Health and Well Being ,Adult ,Asymptomatic Diseases ,Blood Donors ,Brazil ,Chagas Cardiomyopathy ,Cohort Studies ,Follow-Up Studies ,Humans ,Incidence ,Male ,Middle Aged ,Retrospective Studies ,Time Factors ,Trypanosoma cruzi ,Young Adult ,blood donors ,Chagas cardiomyopathy ,Chagas disease ,incidence ,National Heart ,Lung ,and Blood Institute Retrovirus Epidemiology Donor Study-II (REDS-II) ,International Component ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Public Health and Health Services ,Cardiovascular System & Hematology - Abstract
BackgroundVery few studies have measured disease penetrance and prognostic factors of Chagas cardiomyopathy among asymptomatic Trypanosoma cruzi-infected persons.Methods and resultsWe performed a retrospective cohort study among initially healthy blood donors with an index T cruzi-seropositive donation and age-, sex-, and period-matched seronegatives in 1996 to 2002 in the Brazilian cities of São Paulo and Montes Claros. In 2008 to 2010, all subjects underwent medical history, physical examination, ECGs, and echocardiograms. ECG and echocardiogram results were classified by blinded core laboratories, and records with abnormal results were reviewed by a blinded panel of 3 cardiologists who adjudicated the outcome of Chagas cardiomyopathy. Associations with Chagas cardiomyopathy were tested with multivariate logistic regression. Mean follow-up time between index donation and outcome assessment was 10.5 years for the seropositives and 11.1 years for the seronegatives. Among 499 T cruzi seropositives, 120 (24%) had definite Chagas cardiomyopathy, and among 488 T cruzi seronegatives, 24 (5%) had cardiomyopathy, for an incidence difference of 1.85 per 100 person-years attributable to T cruzi infection. Of the 120 seropositives classified as having Chagas cardiomyopathy, only 31 (26%) presented with ejection fraction
- Published
- 2013