PREDICTORS OF SUDDEN CARDIAC DEATH FOR PATIENTS WITH CHAGAS-DISEASE -A HOSPITAL-DERIVED COHORT STUDY

This study was carried out to identify patients with Chagas' disease a t risk of sudden cardiac death, inasmuch as such patients have not bee n recognized thus far. Seventy-four consecutive patients with a positi ve complement fixation test for Chagas' disease prospectively followed up at the Cardiomyopathy Clinic from January 1990 to June 1993 were e ntered into the study. Patients underwent medical history, physical ex amination, serological tests, resting electrocardiography, chest X-ray and two-dimensional echocardiography. Eighteen of 74 (24%) patients d ied during the study period, 8 (10%) suddenly and 10 (14%) from pump f ailure. Sudden death comprised 44% of total deaths. In the univariate model, cardiomegaly in the chest X-ray, left ventricular systolic and diastolic dimension, left ventricular ejection fraction, left atrial d imension and apical aneurysm as detected echocardiographically, and sy stolic blood pressure were associated with sudden cardiac death. In th e multivariate model, however, apical aneurysm and left ventricular di astolic dimension were retained as predictors of sudden cardiac death. We conclude that chagasic patients with apical aneurysm and left vent ricular dilation are at risk of sudden cardiac death.