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

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 f...

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Bibliographic Details
Published in:	Arquivos de neuro-psiquiatria Vol. 76; no. 1; pp. 22 - 25
Main Authors:	Monteiro, Jean M.C., San-Martin, Daniel L., Silva, Beatriz C.G., Jesus, Pedro A.P. de, Oliveira, Jamary
Format:	Journal Article
Language:	English
Published:	Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-01-2018 Academia Brasileira de Neurologia - ABNEURO Academia Brasileira de Neurologia (ABNEURO)
Subjects:	atrial fibrillation Chagas disease NEUROSCIENCES PSYCHIATRY stroke warfarin acidente vascular cerebral atrial fibrillation varfarina Chagas disease doença de Chagas fibrilação atrial stroke warfarin
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0004-282X 1678-4227 1678-4227
DOI:	10.1590/0004-282X20170180