The evolution of electrocardiographic abnormalities in the elderly with Chagas disease during 14 years of follow-up: The Bambui Cohort Study of Aging.

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Bruno Oliveira Figueiredo Brito, Emilly Malveira Lima, Elsayed Z Soliman, Eduardo Fernandes Silva, Maria Fernanda Lima-Costa, Antonio Luiz Pinho Ribeiro
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2023
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Landmark Point
• Online Access: https://doi.org/10.1371/journal.pntd.0011419; https://doaj.org/article/cd87359aba834f89b2e562e7267f4e76

Background The natural history of Chagas disease (ChD) in older ages is largely unknown, and it is a matter of controversy if the disease continues to progress in the elderly. Objective To investigate the evolution of electrocardiographic abnormalities in T. cruzi chronically infected community-dwelling elderly compared to non-infected (NChD) subjects and how it affects this population's survival in a follow-up of 14 years. Methods and results A 12-lead ECG of each individual of the Bambui Cohort Study of Aging was obtained in 1997, 2002, and 2008, and the abnormalities were classified using the Minnesota Code. The influence of ChD on the ECG evolution was assessed by semi-competing risks considering a new ECG abnormality as the primary event and death as the terminal event. A Cox regression model to evaluate the population survival was conducted at a landmark point of 5.5 years. The individuals of both groups were compared according to the following categories: Normal, Maintained, New, and More by the development of ECG major abnormalities between 1997 and 2002. Among the participants, the ChD group had 557 individuals (median age: 68 years) and NChD group had 905 individuals (median age: 67 years). ChD was associated with a higher risk of development of a new ECG abnormality [HR: 2.89 (95% CI 2.28-3.67)]. The development of a new major ECG abnormality increases the risk of death ChD patients compared to those that maintain a normal ECG [HR: 1.93 (95% CI 1.02-3.65)]. Conclusion ChD is still associated with a higher risk of progression to cardiomyopathy in the elderly. The occurrence of a new major ECG abnormality in ChD patients predicts a higher risk of death.