Chagas cardiomyopathy incidence

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We estimated a cardiomyopathy incidence of 1.85 per 100 person-years attributable to T cruzi infection. These results are important on several levels. First, in terms of knowledge about the pathogenesis of Chagas disease, we present well-controlled data on cardiomyopathy incidence among previously asymptomatic T cruzi seropositives. Second, the inclusion of T cruzi seronegatives as control subjects allowed us to validate our screening diagnostic algorithm by estimating the fraction of cardiomyopathy cases resulting from other causes that may be erroneously attributed to Chagas disease. This is important in that endemic countries in Latin America attain living standards that bring with them an increasing incidence of atherosclerotic cardiovascular disease. Third, the data will allow public health authorities to better estimate the potential disease burden and to calculate the costs and benefits of antitrypanosomal treatment in asymptomatic seropositives. Finally, these data will be of interest to the practicing cardiologist in the United States who may increasingly encounter T cruzi–seropositive patients among immigrants from Latin America. They will allow her/him to better estimate prognosis and to better consider treatment.

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