Key result
Nifurtimox treatment in chronic Chagas disease was associated with a lower annual rate of developing ECG alterations compared to a historical untreated cohort.
Why the study?
The study aimed to describe the electrocardiographic and echocardiographic status of chronic Chagas disease patients treated with nifurtimox.
Does nifurtimox prevent electrocardiographic and echocardiographic progression in patients with chronic Chagas disease?
Observational (n=146)
Does nifurtimox prevent electrocardiographic and echocardiographic progression in patients with chronic Chagas disease?
Nifurtimox treatment in chronic Chagas disease is associated with less progression to cardiomyopathy compared to a historical untreated cohort.
Answers are grounded in this paper and cite their sources.
May slow ECG progression with nifurtimox in chronic Chagas; hypothesis-generating and requires randomized confirmation before practice change.
OBJECTIVES: This study aimed to describe the electrocardiographic and echocardiographic status of chronic Chagas disease (cChD) patients treated with nifurtimox. METHODS: An observational study was performed in 146 cChD patients followed over a mean of 7.9 years. RESULTS: Of the 146 patients, 41 (28.1%) with normal electrocardiogram (ECG) at baseline maintained this condition, 34 (23.3%) with altered ECG at baseline normalised the alterations, and 46 (31.5%) with ECG abnormalities at baseline maintained this condition [23 (15.8%) with small alterations]. Finally, 25 cases (17.1%) in indeterminate phase altered the ECG. Differences before and after follow-up (P < 0.001) were found. The percentage of beneficial treatment was different than expected by chance (Z = 4.8; P < 0.001) and the annual percentage of cases that developed ECG alterations was lower than that of a historical cohort of untreated patients (P < 0.001). An echocardiogram was performed in 68 patients with baseline ECG alterations. The ejection fraction (EF) was normal in 57 (83.8%) and abnormal in 11 (16.2%). In 38 patients with ECG abnormalities that did not progress after treatment, EF and segmental motility (SM) were normal in 31 (81.6%) and 26 (68.4%), respectively. In 17 patients with ECG abnormalities, EF and SM were normal in 15 (88.2%) and 14 (82.4%) cases, respectively. CONCLUSION: Less progression to cardiomyopathy compared with a historical untreated cohort as well as the EF/SM results in patients with abnormal ECG that did not progress and in indeterminate cChD that altered the ECG suggests a beneficial effect of nifurtimox.
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Apt et al. (2021) conducted an observational in chronic Chagas disease (n=146). nifurtimox vs. historical cohort of untreated patients was evaluated on development of ECG alterations (p=<0.001). Nifurtimox treatment in chronic Chagas disease was associated with a lower annual rate of developing ECG alterations compared to a historical untreated cohort.
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