{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:08:29Z","timestamp":1788984509997,"version":"build-2803163510"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009680","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000}}],"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>American trypanosomiasis (Chagas disease, CD) affects circa 7 million persons worldwide. While of those persons present the asymptomatic, indeterminate chronic form (ICF), many will eventually progress to cardiac or digestive disorders. We studied a nonconcurrent (retrospective) cohort of patients attending an outpatient CD clinic in Southeastern Brazil, who were admitted while presenting the ICF in the period from 1998 through 2018 and followed until 2019. The outcomes of interest were the progression to cardiac or digestive CD forms. We were also interested in analyzing the impact of Benznidazole therapy on the progression of the disease. Extensive review of medical charts and laboratory files was conducted, collecting data up to year 2019. Demographics (upon inclusion), body mass index, comorbidities (including the Charlson index) and use of Benznidazole were recorded. The outcomes were defined by abnormalities in those test that could not be attributed to other causes. Statistical analysis included univariate and multivariable Cox regression models. Among 379 subjects included in the study, 87 (22.9%) and 100 (26.4%) progressed to cardiac and digestive forms, respectively. In the final multivariable model, cardiac disorders were positively associated with previous coronary syndrome (Hazzard Ratio [HR], 2.42; 95% Confidence Interval [CI], 1.53\u20133.81) and negatively associated with Benznidazole therapy (HR, 0.26; 95%CI, 0.11\u20130.60). On the other hand, female gender was the only independent predictor of progression to digestive forms (HR, 1.56; 95%CI, 1.03\u20132.38). Our results point to the impact of comorbidities on progression do cardiac CD, with possible benefit of the use of Benznidazole.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009680","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T17:43:44Z","timestamp":1628876624000},"page":"e0009680","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Predictors of development of cardiac and digestive disorders among patients with indeterminate chronic Chagas Disease"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8563-5755","authenticated-orcid":true,"given":"Erika Alessandra Pellison","family":"Nunes da Costa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1957-0324","authenticated-orcid":true,"given":"Cassiano","family":"Vict\u00f3ria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4120-1258","authenticated-orcid":true,"given":"Carlos Magno Castelo Branco","family":"Fortaleza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,8,13]]},"reference":[{"key":"pntd.0009680.ref001","volume-title":"Chagas disease (American trypanosomiasis)","author":"World Health Organization","year":"2015"},{"key":"pntd.0009680.ref002","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1590\/S0074-02762002000500002","article-title":"The impact of Chagas disease control in Latin America: a review","volume":"97","author":"JC Dias","year":"2002","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"Suppl 1","key":"pntd.0009680.ref003","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1590\/S0074-02762007005000093","article-title":"Epidemiology of Chagas disease in non-endemic countries: the role of international migration","volume":"102","author":"GA Schmunis","year":"2007","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"pntd.0009680.ref004","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.actatropica.2009.07.019","article-title":"Chagas disease in Spain, the United States and other non-endemic countries","volume":"115","author":"J Gascon","year":"2010","journal-title":"Acta Trop"},{"key":"pntd.0009680.ref005","first-page":"540","article-title":"Chagas disease and transfusion medicine: a perspective from non-endemic countries","volume":"13","author":"A Angheben","year":"2015","journal-title":"Blood Transfus"},{"key":"pntd.0009680.ref006","first-page":"e170298","article-title":"Acute Chagas disease in the state of Par\u00e1, Amazon Region: is it increasing?","volume":"113","author":"VRCD Santos","year":"2018","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"pntd.0009680.ref007","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S1473-3099(01)00065-2","article-title":"Clinical and epidemiological aspects of Chagas disease","volume":"1","author":"A Prata","year":"2001","journal-title":"Lancet Infect Dis"},{"issue":"2","key":"pntd.0009680.ref008","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.idc.2012.03.002","article-title":"American trypanosomiasis (Chagas disease).","volume":"26","author":"A Rassi","year":"2012","journal-title":"Infect Dis Clin North Am"},{"key":"pntd.0009680.ref009","first-page":"135","article-title":"Estudio de intervenci\u00f3n em la evoluci\u00f3n natural de la enfermedad de Chagas. 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