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Anticoagulation in patients with cardiac manifestations of Chagas disease and cardioembolic ischemic stroke

Anticoagulação nas manifestações cardíacas da doença de Chagas e acidente vascular cerebral isquêmico cardioembólico

ABSTRACT

Objectives

To describe anticoagulation characteristics in patients with cardiac complications from Chagas disease and compare participants with and without cardioembolic ischemic stroke (CIS).

Methods

A retrospective cohort of patients with Chagas disease, using anticoagulation, conducted from January 2011 to December 2014.

Results

Forty-two patients with Chagas disease who were using anticoagulation were studied (age 62.9±12.4 years), 59.5% female and 47.6% with previous CIS, 78.6% with non-valvular atrial fibrillation and 69.7% with dilated cardiomyopathy. Warfarin was used in 78.6% of patients and dabigatran (at different times) in 38%. In the warfarin group, those with CIS had more medical appointments per person-years of follow-up (11.7 vs 7.9), a higher proportion of international normalized ratios within the therapeutic range (57% vs 42% medical appointments, p = 0.025) and an eight times higher frequency of minor bleeding (0.64 vs 0.07 medical appointments).

Conclusion

Patients with Chagas disease and previous CIS had better control of INR with a higher frequency of minor bleeding.

Chagas disease; warfarin; stroke; atrial fibrillation

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