Electrocardiographic abnormalities in Chagas disease in the general population : A systematic review and meta-analysis
Rojas, Lyda Z. (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Glisic, Marija (University Medical Center Rotterdam. Department of Epidemiology)
Pletsch-Borba, Laura (University Medical Center Rotterdam. Department of Epidemiology)
Echeverría, Luis E. (Fundación Cardiovascular de Colombia)
Bramer, Wichor (University Medical Center Rotterdam. Medical Library)
Bano, Arjola (University Medical Center Rotterdam. Department of Epidemiology)
Stringa, Najada (University Medical Center Rotterdam. Department of Epidemiology)
Zaciragic, Asija (University Medical Center Rotterdam. Department of Epidemiology)
Kraja, Bledar (University Medical Center Rotterdam. Department of Epidemiology)
Asllanaj, Eralda (University Medical Center Rotterdam. Department of Epidemiology)
Chowdhury, Rajiv (University of Cambridge. Department of Public Health & Primary Care)
Morillo, Carlos A. (McMaster University (Canadà). Department of Medicine)
Rueda-Ochoa, Oscar L. (Universidad Industrial de Santander (Colòmbia))
Franco, Oscar H. (University of Bern)
Muka, Taulant (University Medical Center Rotterdam. Department of Epidemiology)

Date:	2018
Abstract:	Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We performed to systematically review and meta-analyze population-based studies that compared prevalence of overall and specific ECG abnormalities between CD and non-CD participants in the general population. Six databases (EMBASE, Ovid Medline, Web of Science, Cochrane Central, Google Scholar and Lilacs) were searched systematically. Observational studies were included. Odds ratios (OR) were computed using random-effects model. Forty-nine studies were selected, including 34,023(12,276 CD and 21,747 non-CD). Prevalence of overall ECG abnormalities was higher in participants with CD (40. 1%; 95%CIs=39. 2-41. 0) compared to non-CD (24. 1%; 95%CIs=23. 5-24. 7) (OR=2. 78; 95%CIs=2. 37-3. 26). Among specific ECG abnormalities, prevalence of complete right bundle branch block (RBBB) (OR=4. 60; 95%CIs=2. 97-7. 11), left anterior fascicular block (LAFB) (OR=1. 60; 95%CIs=1. 21-2. 13), combination of complete RBBB/LAFB (OR=3. 34; 95%CIs=1. 76-6. 35), first-degree atrioventricular block (A-V B) (OR=1. 71; 95%CIs=1. 25-2. 33), atrial fibrillation (AF) or flutter (OR=2. 11; 95%CIs=1. 40-3. 19) and ventricular extrasystoles (VE) (OR=1. 62; 95%CIs=1. 14-2. 30) was higher in CD compared to non-CD participants. This systematic review and meta-analysis provides an update and synthesis in this field. This research of observational studies indicates a significant excess in prevalence of ECG abnormalities (40. 1%) related to T. cruzi infection in the general population from Chagas endemic regions, being the most common ventricular (RBBB and LAFB), and A-V B (first-degree) node conduction abnormalities as well as arrhythmias (AF or flutter and VE). Also, prevalence of ECG alterations in children was similar to that in adults and suggests earlier onset of cardiac disease. Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We systematically reviewed and meta-analyzed population-based studies that compared prevalence of ECG abnormalities between Chagas disease (CD) and non-CD participants. Forty-nine studies were selected, including 34,023 unique participants. Our meta-analysis of observational studies indicates CD presented almost a threefold increase prevalence of ECG abnormalities than non-CD participants in the general population from Chagas endemic regions, being the most common ventricular (RBBB and LAFB), and A-V B (first-degree) node conduction abnormalities as well as arrhythmias (AF or flutter and VE).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PLoS neglected tropical diseases, Vol. 12 (june 2018) , ISSN 1935-2735

DOI: 10.1371/journal.pntd.0006567
PMID: 29897909

20 p, 1.9 MB

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