دورية أكاديمية
Newly diagnosed rheumatic heart disease among indigenous populations in the Pacific
| العنوان: | Newly diagnosed rheumatic heart disease among indigenous populations in the Pacific |
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| المؤلفون: | Mirabel, M, Tafflet, M, Noel, B, Parks, T, Axler, O, Robert, J, Nadra, M, Phelippeau, G, Descloux, E, Cazorla, C, Missotte, I, Gervolino, S, Barguil, Y, Rouchon, B, Laumond, S, Jubeau, T, Braunstein, C, Empana, J-P, Marijon, E, Jouven, X |
| المصدر: | 1906 ; 1901 |
| بيانات النشر: | BMJ Publishing Group |
| سنة النشر: | 2015 |
| المجموعة: | Imperial College London: Spiral |
| مصطلحات موضوعية: | Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, INFECTIVE ENDOCARDITIS, CARDIAC-SURGERY, FEVER, ECHOCARDIOGRAPHY, MANAGEMENT, CRITERIA, Adolescent, Adult, Cardiovascular Diseases, Cohort Studies, Demography, Female, Hospitalization, Humans, Incidence, Male, New Caledonia, Outcome Assessment, Health Care, Registries, Rheumatic Heart Disease, Secondary Prevention, Severity of Illness Index, Socioeconomic Factors |
| الوصف: | Objectives Rheumatic heart disease (RHD) remains the leading acquired heart disease in the young worldwide. We aimed at assessing outcomes and influencing factors in the contemporary era. Methods Hospital-based cohort in a high-income island nation where RHD remains endemic and the population is captive. All patients admitted with newly diagnosed RHD according to World Heart Federation echocardiographic criteria were enrolled (2005–2013). The incidence of major cardiovascular events (MACEs) including heart failure, peripheral embolism, stroke, heart valve intervention and cardiovascular death was calculated, and their determinants identified. Results Of the 396 patients, 43.9% were male with median age 18 years (IQR 10–40)). 127 (32.1%) patients presented with mild, 131 (33.1%) with moderate and 138 (34.8%) with severe heart valve disease. 205 (51.8%) had features of acute rheumatic fever. 106 (26.8%) presented with at least one MACE. Among the remaining 290 patients, after a median follow-up period of 4.08 (95% CI 1.84 to 6.84) years, 7 patients (2.4%) died and 62 (21.4%) had a first MACE. The annual incidence of first MACE and of heart failure were 59.05‰ (95% CI 44.35 to 73.75) and 29.06‰ (95% CI 19.29 to 38.82), respectively. The severity of RHD at diagnosis (moderate vs mild HR 3.39 (0.95 to 12.12); severe vs mild RHD HR 10.81 (3.11 to 37.62), p<0.001) and ongoing secondary prophylaxis at follow-up (HR 0.27 (0.12 to 0.63), p=0.01) were the two most influential factors associated with MACE. Conclusions Newly diagnosed RHD is associated with poor outcomes, mainly in patients with moderate or severe valve disease and no secondary prophylaxis. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1355-6037 |
| العلاقة: | Heart; http://hdl.handle.net/10044/1/99686Test |
| DOI: | 10.1136/heartjnl-2015-308237 |
| الإتاحة: | https://doi.org/10.1136/heartjnl-2015-308237Test http://hdl.handle.net/10044/1/99686Test |
| حقوق: | © 2015 The Author(s). This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0Test/ ; http://creativecommons.org/licenses/by-nc/4.0Test/ |
| رقم الانضمام: | edsbas.4CBF3802 |
| قاعدة البيانات: | BASE |
| تدمد: | 13556037 |
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| DOI: | 10.1136/heartjnl-2015-308237 |