Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.

<h4>Introduction</h4>Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG) provides a similar prognosis to that of...

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Main Authors: Abilio Augusto Fragata-Filho, Francisco Faustino França, Claudia da Silva Fragata, Angela Maria Lourenço, Cristiane Castro Faccini, Cristiane Aparecida de Jesus Costa
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-03-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0004508&type=printable
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author Abilio Augusto Fragata-Filho
Francisco Faustino França
Claudia da Silva Fragata
Angela Maria Lourenço
Cristiane Castro Faccini
Cristiane Aparecida de Jesus Costa
author_facet Abilio Augusto Fragata-Filho
Francisco Faustino França
Claudia da Silva Fragata
Angela Maria Lourenço
Cristiane Castro Faccini
Cristiane Aparecida de Jesus Costa
author_sort Abilio Augusto Fragata-Filho
collection DOAJ
description <h4>Introduction</h4>Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG) provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ) is the only drug with trypanocidal action available in Brazil.<h4>Materials/methods/results</h4>A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001). The occurrence of electrocardiographic abnormalities and relevant clinical events (heart failure, stroke, total mortality, and cardiovascular death) was less prevalent in treated patients (p <0.001, p: 0.022, p: 0.047 respectively). In multivariate analyses, the parasiticide treatment was an independent variable for persistence of a normal ECG pattern, which was an independent variable in the prevention of significant clinical events. The immunofluorescence titers decreased with the parasitological treatment. However, the small number of tests in untreated patients did not allow the correlation of the decrease of these titers with electrocardiographic alterations.<h4>Conclusion</h4>These data suggest that treatment with benznidazole prevents the occurrence of electrocardiographic alterations. On the other hand, patients who develop ECG abnormalities present with more significant clinical events.
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spelling doaj-art-175828b4bb464c0da47f31a55e3afcda2025-08-20T03:10:58ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352016-03-01103e000450810.1371/journal.pntd.0004508Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.Abilio Augusto Fragata-FilhoFrancisco Faustino FrançaClaudia da Silva FragataAngela Maria LourençoCristiane Castro FacciniCristiane Aparecida de Jesus Costa<h4>Introduction</h4>Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG) provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ) is the only drug with trypanocidal action available in Brazil.<h4>Materials/methods/results</h4>A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001). The occurrence of electrocardiographic abnormalities and relevant clinical events (heart failure, stroke, total mortality, and cardiovascular death) was less prevalent in treated patients (p <0.001, p: 0.022, p: 0.047 respectively). In multivariate analyses, the parasiticide treatment was an independent variable for persistence of a normal ECG pattern, which was an independent variable in the prevention of significant clinical events. The immunofluorescence titers decreased with the parasitological treatment. However, the small number of tests in untreated patients did not allow the correlation of the decrease of these titers with electrocardiographic alterations.<h4>Conclusion</h4>These data suggest that treatment with benznidazole prevents the occurrence of electrocardiographic alterations. On the other hand, patients who develop ECG abnormalities present with more significant clinical events.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0004508&type=printable
spellingShingle Abilio Augusto Fragata-Filho
Francisco Faustino França
Claudia da Silva Fragata
Angela Maria Lourenço
Cristiane Castro Faccini
Cristiane Aparecida de Jesus Costa
Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.
PLoS Neglected Tropical Diseases
title Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.
title_full Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.
title_fullStr Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.
title_full_unstemmed Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.
title_short Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.
title_sort evaluation of parasiticide treatment with benznidazol in the electrocardiographic clinical and serological evolution of chagas disease
url https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0004508&type=printable
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