Nunes MCP, Buss LF, da Silva JLP, et al. - The incidence of cardiomyopathy and death linked with T. cruzi seropositivity has been described.

• Blood banks at 2 Brazilian centers were assessed for selecting participants.

• Researchers included a total of 499 T. cruzi-seropositive blood donors (age 48 ± 10 years, 52% male) as cases and 488 T. cruzi-seronegative individuals (age 49 ± 10 years, 49% male) as controls.

• Recruitment of 101 patients with established Chagas cardiomyopathy was done from a tertiary outpatient service (age 48 ± 8 years, 59% male).

• The mortality in patients with established cardiomyopathy was 80.9 deaths/1,000 person-years (py) (54/101, 53%) and 15.1 deaths/1,000py (17/114, 15%) in T. cruzi-seropositives with cardiomyopathy at baseline.

• Mortality did not differ between T. cruzi-seropositive donors without cardiomyopathy at baseline vs T. cruzi-seronegative donors.

• The incidence of cardiomyopathy was 13.8 events/1,000py (32/262, 12%) vs 4.6 events/1,000 py (11/277, 4%) in T. cruzi-seropositive donors vs seronegative controls, respectively; the absolute incidence difference linked with T. cruzi seropositivity was 9.2 events/1,000py.

• There appeared an association between T. cruzi antibody level at baseline and development of cardiomyopathy.