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恰加斯病中的心源性栓塞性卒中:通过系统评价揭示未充分探索的关联

Cardioembolic stroke in Chagas disease: unraveling the underexplored connection through a systematic review.

作者信息

Vásconez-González Jorge, Miño Camila, Izquierdo-Condoy Juan S, Salazar-Santoliva Camila, López-Cortés Andrés, Ortiz-Prado Esteban

机构信息

One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador.

Department of Public Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.

出版信息

Trop Dis Travel Med Vaccines. 2024 Sep 1;10(1):16. doi: 10.1186/s40794-024-00227-y.

Abstract

BACKGROUND

Chagas disease (CD), triggered by the Trypanosoma cruzi parasite, is originally endemic across Latin America, affecting millions. While cardiac complications are widely recognized, the association between CD and stroke remains underexplored. This systematic review aims to elucidate the relationship between CD and stroke, highlighting the cardioembolic origins of stroke in CD patients and assessing the elevated stroke risk compared to non-infected individuals.

METHODOLOGY

Adhering to the PRISMA guidelines, we conducted a comprehensive search in PubMed and Scopus databases without date restrictions, including articles in both Spanish and English. This approach enabled the identification and analysis of relevant studies to understand the interplay between CD and stroke risk.

RESULTS

Our analysis of 25 selected studies indicates that strokes in CD patients predominantly arise from cardioembolic sources. The data underscore a significant increase in stroke risk among individuals infected with T. cruzi compared to uninfected counterparts. Additionally, CD patients face a higher stroke and mortality risk than those with other heart failure etiologies, irrespective of disease severity.

CONCLUSION

The review establishes CD as a critical contributor to stroke incidence, emphasizing the need for heightened awareness and diagnosis of CD in stroke patients, particularly in regions with high CD prevalence. Recognizing the increased stroke risk associated with T. cruzi infection is crucial for developing targeted educational and preventive strategies in endemic areas.

摘要

背景

恰加斯病(CD)由克氏锥虫寄生虫引发,最初在拉丁美洲流行,影响着数百万人。虽然心脏并发症已广为人知,但CD与中风之间的关联仍未得到充分探索。本系统评价旨在阐明CD与中风之间的关系,突出CD患者中风的心源性栓塞起源,并评估与未感染者相比升高的中风风险。

方法

遵循PRISMA指南,我们在PubMed和Scopus数据库中进行了全面检索,无日期限制,包括西班牙语和英语文章。这种方法有助于识别和分析相关研究,以了解CD与中风风险之间的相互作用。

结果

我们对25项选定研究的分析表明,CD患者的中风主要源于心源性栓塞。数据强调,与未感染的人相比,感染克氏锥虫的个体中风风险显著增加。此外,无论疾病严重程度如何,CD患者面临的中风和死亡风险都高于其他心力衰竭病因的患者。

结论

该评价确定CD是中风发病率的一个关键因素,强调需要提高对中风患者中CD的认识和诊断,特别是在CD高流行地区。认识到与克氏锥虫感染相关的中风风险增加对于在流行地区制定有针对性的教育和预防策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba7/11366139/2b38f0c72748/40794_2024_227_Fig1_HTML.jpg

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