585. Progression of Baseline Electrocardiogram Abnormalities in Chagas Patients Undergoing Treatment
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWEEK2016_CHAGAS_POSTER.jpg (3.9 MB)
  • Background: In Chagas disease, baseline electrocardiogram (ECG) abnormalities correlate with disease severity. The impact of Chagas treatment with nifurtimox and/or benzinidazole on the evolution of ECG abnormalities is unknown. Methods: , Initial and post-treatment ECGs were obtained in a prospective cohort of Chagas patients undergoing therapy with nifurtimox or benzinidazole. ECG disease progression was defined as development of a (1) new bundle branch block (2) change in underlying rhythm (3) shift in QRS axis or (4) development of frequent PVCs. ECG disease progression was compared in those with and without baseline abnormalities pre- and post-therapy using the Fisher’s exact test. Results: 59 patients were recruited. 18 patients underwent treatment with benzinidazole and 41 with nifurtimox. 3 patients crossed over from nifurtimox to benzinidazole and one patient crossed from benzinidazole to nifurtimox. 5 patients did not complete a full course of therapy with either drug. Patients were followed for an average of 3.9 years and there were no differences between groups with regards to length of follow-up, age, or drug used. 0 / 30 patients with normal ECGs developed an abnormal ECG during the study period compared with 7 / 29 patients with baseline ECG abnormalities who developed disease progression (p=0.005) (fig 1.). Conclusion: Over an average follow-up of 3.9 years, patients with normal baseline ECGs did not have significant changes during a course of treatment; but those with baseline abnormal EKGs had significant progression of their conduction system disease. These preliminary results mirror those of other studies suggesting that early, but not late treatment may prevent Chagas cardiovascular disease progression. Figure 1. BZN = benzinidazole. NFX = nifurtimox. ECG = electrocardiogram.
    Jonathan Soverow, MD, MPH1, Salvador Hernandez, M.D.2, Carmen Flores, MD3, Gracia Viana, MD1 and Sheba Meymandi, MD4, (1)Olive View-UCLA Center of Excellence for Chagas Disease, Sylmar, CA, (2)Cardiology, Olive View-UCLA Medical Center, Sylmar, CA, (3)Olive View-UCLA Center for Excellence for Chagas Disease, Sylmar, CA, (4)Medicine/Cardiology, Center of Excellence for Chagas Disease/Olive View-UCLA Medical Center, Sylmar, CA

    Disclosures:

    J. Soverow, None

    S. Hernandez, None

    C. Flores, None

    G. Viana, None

    S. Meymandi, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.