1268. Prevalence of Chagas Disease in Latin-American Immigrants with Non-Ischemic Cardiomyopathy in New York City
Session: Poster Abstract Session: Travel/Tropical Medicine and Parasitology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • PosterChagasIDSA_2011_10_10_20_23_33_836.pdf (319.1 kB)
  • Background:  

    Because Chagas disease cardiomyopathy (CM), the leading cause of CM in Latin America, occurs 10 - 30 years after infection, infected immigrants may develop CM while living in non-endemic countries. Anti-parasitic treatment is recommended for infected persons, < 50 years, before congestive heart failure (CHF) occurs.  A cross-sectional study of Latin American-born adults with symptomatic non-ischemic CM determined the prevalence of Chagas disease.  While it is unclear if anti-parasitic therapy would benefit the participants, documenting Chagas would demonstrate the need for earlier screening. 

    Methods: 

    Patients with non-ischemic CM were recruited from Elmhurst Hospital Center’s Cardiology Clinic.  Ischemic cardiac disease was diagnosed in patients with a positive cardiac angiogram, positive stress test, or history of coronary artery bypass, cardiac stent, or myocardial infarction.  Non-ischemic CM was diagnosed in patients without ischemic disease who had an ejection fraction (EF) < 50%.  Consented participants completed a structured questionnaire.  Blood was sent to CDC for Trypanosoma cruzi antibody testing by enzyme immunoassay, indirect immunofluorescence, and, when these tests were discordant, immunoblot analysis of trypomastigote excreted-secreted antigens.  Chagas disease was diagnosed with 2 positive tests.

    Results: 

    The 27 participants were 30 - 94 years, 66% men, and from 9 Latin American countries.  The 15% (4/27) diagnosed with Chagas were 51 - 73, 75% men, and from 4 Latin American countries.  Infected participants were more likely than uninfected participants to have chest pain (p=0.004, Fisher’s Exact) and answer ‘yes’ when asked if they had a Chagas-infected family member (p=0.02, Fisher’s Exact). The two groups did not differ in blood pressure, EF, right bundle branch block, left anterior hemiblock, atrioventricular block, dysrhythmias, or symptoms of CHF.

    Conclusion: 

    Our data suggests that 15% of non-ischemic CM in Latin American immigrants is caused by Chagas disease, and therefore, may be preventable. Future research will determine if chest pain or patient report of a Chagas-infected family member is helpful in identifying patients earlier in their disease who may benefit from anti-parasitic therapy.


    Subject Category: T. Travel/tropical medicine and parasitology

    Luciano Kapelusznik, MD1, Susan Montgomery, DVM2, Arti Shah, MD3, Francis Steurer, MS2, Deborah Varela, MD1, David Rubinstein, MD3, Daniel Caplivski, MD1, Sean Pinney, MD1 and Stephanie Factor, MD, MPH1, (1)Mount Sinai School of Medicine, New York, NY, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)Elmhurst Hospital Center, Elmhurst, NY

    Disclosures:

    L. Kapelusznik, None

    S. Montgomery, None

    A. Shah, None

    F. Steurer, None

    D. Varela, None

    D. Rubinstein, None

    D. Caplivski, None

    S. Pinney, None

    S. Factor, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.