Savio Cardoso et al. Clerio Francisco de Azevedo Filho Fábio Fernandes Barbara Ianni … Jorge Andion Torreão Mateus Diniz Marques Luiz Francisco Rodrigues de Ávila Raul Santos Filho Charles Mady Roberto Kalil-Filho José Antônio Franchine Ramires Marcio Sommer Bittencourt Carlos E. Rochitte
Abstract
Background
In Chagas’ disease endemic regions, there has been for many years a recurrent empirical observation that coronary artery disease (CAD) is uncommon in patients with Chagas’ disease. Previous pathological and invasive coronary angiography studies led to controversial results.
Objective
We sought to investigate whether CAD is less prevalent and less severe in patients with chronic Chagas’ disease when compared with a matched population with a similar CAD risk profile.
Methods
A total of 86 participants, 43 consecutive patients with chronic Chagas’ disease and 43 asymptomatic individuals, without any prior history of cardiac disease or known CAD (control group), were included. Patients and controls were matched according to gender, age, and Framingham risk score. All participants underwent coronary calcium scoring and coronary computed tomography angiography on a 320-row detector scanner. Statistical significance level adopted was p < 0.05.
Results
The coronary artery calcium score (CACS) was significantly lower in patients with Chagas’ disease than in controls (p 10 (OR: 0.11, 95%CI: 0.01-0.87, p=0.04) and for the presence of any stenosis (OR: 0.06, 95%CI: 0.01-0.47, p=0.001). Propensity score matching also indicated an effect of Chagas disease on the CACS (-21.6 points in the absolute score and 25% less of patients with CACS >10, p=0.015).
Conclusions
CAD is less prevalent and less severe in patients with chronic Chagas’ disease when compared with a matched population with a similar CAD risk profile. (Arq Bras Cardiol. 2020; 115(6):1051-1060)