Heart Failure Drug Shows Limited Benefit in Chagas Disease patients, Study Finds
New research published December 3, 2025, in JAMA indicates that sacubitril/valsartan, a commonly prescribed heart failure therapy, demonstrated limited efficacy in patients with heart failure (HF) caused by Chagas disease. The open-label, multicenter randomized clinical trial challenges existing treatment paradigms and highlights the need for tailored approaches to managing cardiac complications stemming from this parasitic infection.
Chagas disease, prevalent in Latin America and increasingly found in the United States, can lead to chronic heart failure, often with unique characteristics compared to other forms of the condition. This study’s findings are particularly relevant for the estimated millions affected globally, as current heart failure treatments may not provide the same level of benefit. Researchers emphasize the importance of understanding the specific needs of this patient population, who often present with right ventricular dysfunction and lower blood pressure.
The trial compared sacubitril/valsartan to enalapril in patients with HF due to Chagas disease. While the study revealed certain limitations, including underrepresentation of female individuals, Black patients, and those with more advanced symptoms, it underscored the complexities of treating this specific form of heart failure.
Researchers noted that follow-up NT-proBNP measurements were taken relatively early due to concerns about missing data from sudden death. The results are not broadly applicable to all Chagas cardiomyopathy patients, specifically those with mildly reduced or preserved ejection fraction.
“Fully understanding the safety of HF treatments in this population is important, as these patients have more dysfunction of the right ventricle and lower blood pressure compared with other HF etiologies,” the study authors wrote.
References:
- Lopes RD, Bocchie EA, EcheverrÍa LE, et al. Sacubitril/valsartan vs enalapril in heart failure due to Chagas disease: an open-label, multicenter randomized clinical trial. JAMA. Published online December 3, 2025. doi:10.1001/jama.2025.19808
- About Chagas disease. Centers for Disease Control and Prevention. September 4, 2024. Accessed December 3, 2025. https://www.cdc.gov/chagas/about/index.html
