Abstract 15322: Pacinchagas-crt: A Cohort Study of Cardiac Resynchronization Therapy in Patients With Chronic Chagas Cardiomyopathy

Abstract

Background: Cardiac resynchronization therapy (CRT) is an established procedure for patients with heart failure (HF). However, trials evaluating its efficacy did not include patients with chronic Chagas cardiomyopathy (CCC), an important cause of HF in endemic countries. We aimed to assess the role of CRT in a cohort of patients with CCC. Methods: This was a retrospective study of consecutive CCC patients who underwent CRT between January 2005 and December 2012. We compared the outcomes of CCC patients who underwent CRT (CCC-CRT group) with those of ischemic and dilated cardiomyopathy patients who underwent CRT (CRT-control group) in the same period and with those of CCC patients with induced left bundle branch block (LBBB) who did not undergo CRT (CCC-control group). The primary endpoint was all-cause mortality and the secondary endpoint was echocardiographic changes, at least 24 months after CRT. Results: There were 115 patients in the CCC-CRT group, 311 in the CRT-control group, and 16 in the CCC-control group. The annual mortality rates were 25.4%, 10.9%, and 42.9%, respectively. Multivariate analysis adjusted for potential confounders showed that the CCC-CRT group had a two-fold (hazard ratio [HR] 2.11 [1.56-2.86], P<0.001) higher risk of death compared to the CRT-control group, and that the CCC-control group had an almost three-fold (HR 2.78 [1.09-7.01], P=0.032) higher risk of death compared to the CCC-CRT group. Conclusions: This cohort study showed that CRT has a favorable impact in patients with CCC, despite their worse prognosis compared to patients with other cardiomyopathies who undergo CRT.