P3413Prevalence of cardiac abnormalities in Chagas disease in the general population: a systematic review and meta-analysis

Abstract

Background/Introduction: Chagas' disease (CD), caused by the parasite Trypanosoma cruzi, affects more than 8 million people worldwide, and is a major public health concern in North, Central and South America. Cardiac abnormalities (CA) are the main cause of morbidity in chronic CD, but whether the prevalence of overall and specific CA is different between CD and non-CD subjects, in the general population, remains unclear. Purpose: To systematically review and meta-analyze population-based studies that compared the prevalence of overall and subtypes of CA between CD and non-CD subjects. Methods: The electronic databases Ovid Medline, EMBASE, Cochrane Central, Web of Science, PUBMED and Google Scholar were searched for studies comparing, the prevalence of overall and subtypes of CA between seropositive and seronegative CD subjects in the general population. Reference lists of selected studies and related reviews were searched to identify additional publications. Data were extracted by two independent reviewers using a predesigned data collection form. Overall and specific CA (ventricular conduction defects, atrioventricular block, arrhythmias and other abnormalities) were diagnosed by electrocardiogram. Odds ratios (OR) were computed using random-effects model. Results: Out of 3,517 initially identified citations, 45 observationales studies were selected, including (31,157 participants; 11,953 seropositive and 19,204 seronegative for CD). The prevalence of overall CA was significantly higher (OR= 2.78; 95% CIs=2.38-3.25) in subjects with CD (41.2%; 95% CIs=40.3-42.0) compared to subjects without CD (25.7%; 95% CIs=25.0-26.3) (Figure 1). The results were similar in children and adults. Among specific CA, prevalences of complete right bundle branch block (OR=5.42; 95% CIs=3.41-8.62), left anterior fascicular block (OR=1.55; 95% CIs=1.12-2.13), first-degree atrioventricular block (OR=1.69; 95% CIs=1.23-2.33), atrial or flutter fibrillation (OR=2.11; 95% CIs=1.40-3.19) and ventricular extrasystoles (OR=1.53; 95% CIs=1.06-2.20) were higher in CD subjects compared to subjects who did not have CD. Conclusions: The findings of this review indicate excess prevalence of cardiac abnormalities in both children and adults due to Chagas disease in the general population, particularly ventricular conduction abnormalities and arrhythmias. (Table Presented).