Cardioembolic stroke in Chagas disease: unraveling the underexplored connection through a systematic review

Abstract Background Chagas disease (CD), triggered by the Trypanosoma cruzi parasite, is originally endemic across Latin America, affecting millions. While cardiac complications are widely recognized, the association between CD and stroke remains underexplored. This systematic review aims to elucida...

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Bibliographic Details
Published in:Tropical Diseases, Travel Medicine and Vaccines
Main Authors: Jorge Vásconez-González, Camila Miño, Juan S. Izquierdo-Condoy, Camila Salazar-Santoliva, Andrés López-Cortés, Esteban Ortiz-Prado
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2024
Subjects:
Chagas Disease
Trypanosoma Cruzi
Stroke risk
Cardioembolic Stroke
Cerebrovascular complications
Systematic review
Arctic medicine. Tropical medicine
RC955-962
Arctic
Prisma
Online Access:https://doi.org/10.1186/s40794-024-00227-y
https://doaj.org/article/13ff4552bc414cb6a129eeb1d4584a74
Description
Summary:Abstract Background Chagas disease (CD), triggered by the Trypanosoma cruzi parasite, is originally endemic across Latin America, affecting millions. While cardiac complications are widely recognized, the association between CD and stroke remains underexplored. This systematic review aims to elucidate the relationship between CD and stroke, highlighting the cardioembolic origins of stroke in CD patients and assessing the elevated stroke risk compared to non-infected individuals. Methodology Adhering to the PRISMA guidelines, we conducted a comprehensive search in PubMed and Scopus databases without date restrictions, including articles in both Spanish and English. This approach enabled the identification and analysis of relevant studies to understand the interplay between CD and stroke risk. Results Our analysis of 25 selected studies indicates that strokes in CD patients predominantly arise from cardioembolic sources. The data underscore a significant increase in stroke risk among individuals infected with T. cruzi compared to uninfected counterparts. Additionally, CD patients face a higher stroke and mortality risk than those with other heart failure etiologies, irrespective of disease severity. Conclusion The review establishes CD as a critical contributor to stroke incidence, emphasizing the need for heightened awareness and diagnosis of CD in stroke patients, particularly in regions with high CD prevalence. Recognizing the increased stroke risk associated with T. cruzi infection is crucial for developing targeted educational and preventive strategies in endemic areas.

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