Pharmacological interventions for treating heart failure in patients with Chagas cardiomyopathy

Abstract

The results were inconclusive that carvedilol reduced all-cause mortality or improved quality of life more than placebo. The safety profile of carvedilol for Chagas cardiomyopathy remains unclear. One study assessed the e ect of rosuvastatin versus placebo, but did not show an e ect size. Therefore, the results from available clinical trials neither support nor reject the use of carvedilol or rosuvastatin in treating this clinical entity. Further investigation is warranted to investigate the exact applicability of conventional heart failure treatment agents in Chagas cardiomyopathy. Quality of evidenceOur confidence in the results of this review is very low because the included trials had a high risk of bias and were small. which generated imprecise results.

Effect of statins on inflammation and cardiac function in patients with chronic Chagas disease: A protocol for pathophysiological studies in a multicenter, placebo-controlled, proof-of-concept phase II trial

“…There is only one mention of the use of rosuvastatin in treating CD, but the quality of the provided evidence is poor [61]. Other clinical trials that focused only on symptomatic treatment of heart failure associated with CD have assayed amiodarone [62], carvedilol [63], and angiotensin-modulating drugs [64].…”

Effect of statins on inflammation and cardiac function in patients with chronic Chagas disease: A protocol for pathophysiological studies in a multicenter, placebo-controlled, proof-of-concept phase II trial

“…There is only one mention of the use of rosuvastatin in treating CD, but the quality of the provided evidence is poor [61]. Other clinical trials that focused only on symptomatic treatment of heart failure associated with CD have assayed amiodarone [62], carvedilol [63], and angiotensin-modulating drugs [64].…”

Chagas Disease Cardiomyopathy

“…It is recommended over ACEIs and ARBs in patients with heart failure with reduced EF in conjunction with other standard heart failure treatment as it demonstrates improved morbidity and mortality 54 . These medications halt neurohormonal activation, prevent remodeling, and can improve functional class before the introduction of a β-blocker medication 55 (Table).…”

Chagas heart disease: An overview of diagnosis, manifestations, treatment, and care

“…However, the recommended full doses of these drugs are often not reached, as patients with CHD have a high prevalence of atrioventricular block and autonomic nervous system disorders. Carvedilol is the most frequently used beta-blocker in CHD, although the quality of evidence is low and based on a meta-analysis that included 69 participants and found a lower all-cause mortality in the carvedilol group than in the placebo group[ 96 ].…”

Effect of statins on inflammation and cardiac function in patients with chronic Chagas disease: A protocol for pathophysiological studies in a multicenter, placebo-controlled, proof-of-concept phase II trial

“…There is only one mention of the use of rosuvastatin in treating CD, but the quality of the provided evidence is poor [61]. Other clinical trials that focused only on symptomatic treatment of heart failure associated with CD have assayed amiodarone [62], carvedilol [63], and angiotensin-modulating drugs [64].…”

Chagas Disease Cardiomyopathy

“…It is recommended over ACEIs and ARBs in patients with heart failure with reduced EF in conjunction with other standard heart failure treatment as it demonstrates improved morbidity and mortality 54 . These medications halt neurohormonal activation, prevent remodeling, and can improve functional class before the introduction of a β-blocker medication 55 (Table).…”

Chagas heart disease: An overview of diagnosis, manifestations, treatment, and care

“…However, the recommended full doses of these drugs are often not reached, as patients with CHD have a high prevalence of atrioventricular block and autonomic nervous system disorders. Carvedilol is the most frequently used beta-blocker in CHD, although the quality of evidence is low and based on a meta-analysis that included 69 participants and found a lower all-cause mortality in the carvedilol group than in the placebo group[ 96 ].…”

Effect of statins on inflammation and cardiac function in patients with chronic Chagas disease: A protocol for pathophysiological studies in a multicenter, placebo-controlled, proof-of-concept phase II trial

“…There is only one mention of the use of rosuvastatin in treating CD, but the quality of the provided evidence is poor [61]. Other clinical trials that focused only on symptomatic treatment of heart failure associated with CD have assayed amiodarone [62], carvedilol [63], and angiotensin-modulating drugs [64].…”

Chagas Disease Cardiomyopathy

“…It is recommended over ACEIs and ARBs in patients with heart failure with reduced EF in conjunction with other standard heart failure treatment as it demonstrates improved morbidity and mortality 54 . These medications halt neurohormonal activation, prevent remodeling, and can improve functional class before the introduction of a β-blocker medication 55 (Table).…”

Chagas heart disease: An overview of diagnosis, manifestations, treatment, and care

“…However, the recommended full doses of these drugs are often not reached, as patients with CHD have a high prevalence of atrioventricular block and autonomic nervous system disorders. Carvedilol is the most frequently used beta-blocker in CHD, although the quality of evidence is low and based on a meta-analysis that included 69 participants and found a lower all-cause mortality in the carvedilol group than in the placebo group[ 96 ].…”