%0 Journal Article
%T Chagas disease stroke and associated risk factors: A case-control study.
%A de Melo ES
%A de Paiva Bezerra R
%A de Holanda AC
%A Lira E Silva MJ
%A Travassos PP
%A da Silva TFL
%A de Azevedo Oliveira GM
%A Alves SMM
%A Medeiros CA
%A da Silveira Barros MDND
%A de Oliveira WA
%A Silva GS
%A de Andrade Valença LPA
%J J Stroke Cerebrovasc Dis
%V 33
%N 1
%D 2024 Jan 24
%M 38006768
%F 2.677
%R 10.1016/j.jstrokecerebrovasdis.2023.107463
%X BACKGROUND: The intricate relationship between Chagas disease and ischemic stroke remains unclear. Limited evidence exists concerning secondary prophylaxis, etiological diagnosis, and stroke-related determinants. This study aims to discern factors linked to stroke in Chagas disease by contrasting patients with and without a history of ischemic stroke.
METHODS: Retrospective data from all outpatient Chagas disease patients from two Brazilian hospitals - one Chagas center and one stroke clinic - were examined. Descriptive analyses were conducted to identify stroke-associated factors. Variables were compared between patients with and without ischemic stroke history.
RESULTS: Among 678 subjects, 72 had experienced stroke. Univariate associations with stroke included male gender, heart failure, prior or ongoing alcoholism, electrocardiographic features (non-sinus rhythm, left bundle branch, right bundle branch block, left anterosuperior fascicular block, atrial fibrillation), as well as echocardiographic findings indicative of reduced left ventricular ejection fraction and segmental abnormalities. After logistic regression (multivariate analysis), congestive heart failure, right bundle branch block, left anterosuperior divisional block, and atrial fibrillation retained independent associations.
CONCLUSIONS: In this study, cardiac involvement emerged as the predominant factor correlated with stroke in Chagas disease. While atherosclerosis-related risk factors were prevalent, their influence on ischemic stroke in Chagas disease appeared limited.