Dados do Trabalho

Título

Chagas' disease and ischemic stroke: A study of associated factors

Resumo

Introduction: Chagas' disease is an independent risk factor for stroke. The management and prevention of these cases are based on incomplete information or extrapolations of knowledge about other stroke etiologies. The occurrence of strokes without cardiac involvement in Chagas' disease has also been documented.
Objective: The present study aims to verify the risk factors (clinical and laboratory) for the occurrence of stroke in patients with Chagas' disease.
Methods: This is a cross-sectional study that included patients seen at the Chagas Disease outpatient clinic in the Cardiovascular Emergency Room of Pernambuco and the Neurovascular Outpatient Clinic at Hospital São Paulo - Federal University of São Paulo. Demographic, clinical and complementary cardiological exams (echocardiogram, electrocardiography, Holter-electrocardiography), in addition to those related to the investigation of stroke and its mechanisms were analyzed. It was defined as significant p <0.05. The local research ethics committee of each participating center approved this study.
Results: The sample consisted of 678 patients, 72 (10.6%) had a confirmed stroke. The mean age of the patients was 62 years old (SD = ± 12.3) ranging from 14 to 94 years old, mostly women 67.6% and born in the state of Pernambuco (82%). The variables that showed a statistically significant association with stroke were: sex, congestive heart failure, alcoholism, not-sinus electrocardiogram, left bundle branch block, right bundle branch block, anterosuperior divisional block, atrial fibrillation, left ventricular ejection fraction, and use of oral anticoagulants (p <0.05). Variables with p≤0.20, except for drugs that are a consequence and not a cause of stroke, were included in the multivariate analysis, with heart failure, atrial fibrillation, right bundle branch block and anterosuperior divisional block being the risk factors that remained significant.
Conclusion: Although risk factors for atheromatosis such as diabetes, dyslipidemia, obesity, smoking and alcoholism are present in patients with stroke and Chagas disease, the variables related to heart disease are the most related to the occurrence of stroke.