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.
RESUMO
Objetivos descrever as características da anticoagulação em pacientes com manifestações cardíacas
da doença de Chagas (MCDC) e comparar os participantes com sem acidente vascular cerebral
isquêmico cardioembólico (AVCIC).
Resultados 42 pacientes com MCDC em anticoagulação foram estudados (62,9 ± 12,4 anos), 59,5%
do sexo feminino e 47,6% com AVCIC prévio, 78,6% portadores de fibrilação atrial não valvar e 69,7% com cardiomiopatia
dilatada. Varfarina foi utilizada em 78,6% dos pacientes e dabigatrana em 38% (em
momentos diferentes). No grupo da varfarina, aqueles com AVCIC tiveram mais consultas médicas por pessoas-ano de seguimento (11,7 vs 7,9), maior
taxa de RNI na faixa terapêutica (57% vs 42% consultas médicas, p = 0,025) e uma frequência
oito vezes maior de sangramento menor (0,64 vs. 0,07 consultas médicas).
Conclusão pacientes com MCDC e AVCIC prévio têm melhor controle de RNI com maior frequência de sangramento menor.
Chagas disease - warfarin - stroke - atrial fibrillation
doença de Chagas - varfarina - acidente vascular cerebral - fibrilação atrial
