Systematic review finds evidence gap for amiodarone in chronic Chagas cardiomyopathy

BackgroundChagas disease (CD) is a neglected tropical illness caused by Trypanosoma cruzi, with a high prevalence in Latin America. Arrhythmias are common in patients with Chagas cardiomyopathy, and amiodarone (AMIO) has been widely used in their management. Recent studies have also suggested a potential role for AMIO as a trypanocidal agent. This review aims to evaluate the current evidence regarding AMIO therapy for the treatment of patients with CD.MethodologyThis study combines bibliometric and systematic review approaches to explore the use of AMIO in the treatment of CD. The literature search was conducted in PubMed. Bibliometric analyses were performed using the Bibliometrix 2.2.1 package in R 3.6 (R Core Team, 2019). Relationship mapping was carried out using VOSviewer 1.6.16 (https://www.vosviewer.com/) to visualize bibliographic network structures. The systematic review component followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines.Principal FindingsA total of 52 original articles published in 35 journals were included, involving contributions from 269 authors, predominantly from Latin America. Brazil was the leading contributor, followed by Venezuela, the United States, Argentina, and Spain. The bibliometric analysis identified several emerging trends: (1) treatment outcomes such as mortality and hospitalization; (2) the antiarrhythmic effects of AMIO; (3) potential trypanocidal effects of AMIO; (4) the use of AMIO in combination with other drugs for etiological treatment; and (5) its possible anti-inflammatory effects.ConclusionThis review highlights a significant gap in literature, specifically the lack of rigorous clinical studies evaluating the impact of AMIO in patients with chronic Chagas cardiomyopathy (CCC). Additionally, we identify promising avenues for future research to better understand AMIO’s therapeutic role in the management of CD.