Cardiovascular outcomes of chagas-induced non-ischemic cardiomyopathy versus other nonischemic cardiomyopathies: a regression matched national cohort analysis

OBJECTIVES: Chagas disease, caused by Trypanosoma cruzi, is a parasitic infection endemic to Latin America and is increasingly prevalent in the United States. This study examines mortality, heart failure, arrhythmias, cardiogenic shock, and the need for heart transplantation in Chagas patients over five years in the United States. METHODS: We selected all non-ischemic cardiomyopathy (NICM) patients from the National Inpatient Sample Database from 2016 to 2020 and compared them to Chagas-induced NICM. RESULTS: A total of 783,535 patients had non-ischemic cardiomyopathy (NICM), with 250 cases being secondary to Chagas disease. Chagas NICM was predominantly seen in the Hispanic population. Patients with Chagas NICM have significantly higher odds of receiving a heart transplant (OR 15.48; P<0.05), particularly in the context of a high incidence of cardiogenic shock due to end-stage heart failure or severe myocarditis (OR 2.7; P<0.05). Furthermore, these patients demonstrate a higher incidence of ventricular fibrillation (OR 4.87; P<0.05) and pericardial effusion (OR 3.75; P<0.05) compared to other forms of NICM. They are frequently associated with the need for pacemaker placement (OR 2.80; P<0.05), likely due to ventricular fibrillation and conduction blocks. The odds of in-hospital mortality were similar between patients with Chagas NICM and those with other NICM patients. CONCLUSION: Patients with Chagas cardiomyopathy are more likely to experience cardiogenic shock, ventricular fibrillation, and pericardial effusion. They also face an increased risk of needing an ICD and heart transplant. Further research is necessary on this subject.