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Introduction:Chagas disease (CD) is a vector-born illness caused by Trypanosoma Cruzi and can lead to dilated cardiomyopathy among other cardiac and systemic manifestations. Little is known about the ethnic distribution of CD in the United States amidst recently changing migration and transmission rates and trends. Furthermore, the effect of ethnicity on clinical outcomes has not been reported before.Methods:We screened the NIS database for hospital discharges with primary diagnosis of CD between 2004 and 2014. Patient demographics, incidence of death and ischemic stroke prior to discharge were analyzed. Patients were divided into 4 different ethnic groups; White, Hispanic, Black and other. The NIS is a database of retrospectively collected data that contains more than 96% of discharges from community hospitals and academic centers in the US. The database utilizes International Classification of Disease (ICD) 9 code of diagnosis which is derived from billing data submitted by participating hospitals.Results:The analytic sample included 390 patients, which was equivalent to a population-based sample of 1880 patients (Table). Mean age was 55.90, 46% were male, 74.7% were Hispanic, 15.7% were White and 2.1% were Black. White patients had higher incidence of death compared to Hispanic patients (5.46% vs 1.78%, OR =3.18, unadjusted p-value = 0.0003) and ischemic stroke (3.67% vs 1.47%, OR= 2.55, unadjusted p-value = 0.0142).Conclusions:Although Chagas Disease has been traditionally known to largely affect patients from Latin America and of Hispanic ethnicity, this study demonstrates that other ethnicities in the US are also affected. Furthermore, ethnic variation might have an effect on clinical outcomes including in-hospital mortality and the incidence of ischemic stroke.

Regadenoson is a selective adenosine 2a (A2a) receptor agonist that is used in cardiac stress testing to evaluate for ischemic heart disease and has largely replaced adenosine in the modern era. Since adenosine receptors are involved in synaptic transmission between neurons throughout the central nervous system (CNS) including the cerebral cortex, hippocampus, and other structures as well, regadenoson can lower the seizure threshold in susceptible individuals. Epileptogenic activity is an uncommon yet potentially severe adverse effect of regadenoson use, and therefore, more awareness is required in screening patients at risk and evaluating alternate ways to investigate coronary artery disease (CAD) in susceptible individuals.