| Autor: |
Zühlke, Liesl, Engel, Mark E., Karthikeyan, Ganesan, Rangarajan, Sumathy, Mackie, Pam, Cupido, Blanche, Mauff, Katya, Islam, Shofiqul, Joachim, Alexia, Daniels, Rezeen, Francis, Veronica, Ogendo, Stephen, Gitura, Bernard, Mondo, Charles, Okello, Emmy, Lwabi, Peter, Al-Kebsi, Mohammed M., Hugo-Hamman, Christopher, Sheta, Sahar S., Haileamlak, Abraham |
| Zdroj: |
European Heart Journal; 5/7/2015, Vol. 36 Issue 18, p1115-1122a, 9p, 2 Charts, 5 Graphs |
| Abstrakt: |
Aims Rheumatic heart disease (RHD) accounts for over a million premature deaths annually; however, there is little contemporary information on presentation, complications, and treatment. Methods and results This prospective registry enrolled 3343 patients (median age 28 years, 66.2% female) presenting with RHD at 25 hospitals in 12 African countries, India, and Yemen between January 2010 and November 2012. The majority (63.9%) had moderate-to-severe multivalvular disease complicated by congestive heart failure (33.4%), pulmonary hypertension (28.8%), atrial fibrillation (AF) (21.8%), stroke (7.1%), infective endocarditis (4%), and major bleeding (2.7%). One-quarter of adults and 5.3% of children had decreased left ventricular (LV) systolic function; 23% of adults and 14.1% of children had dilated LVs. Fifty-five percent (n = 1761) of patients were on secondary antibiotic prophylaxis. Oral anticoagulantswere prescribed in 69.5% (n = 946) of patients with mechanical valves (n = 501), AF (n = 397), and high-risk mitral stenosis in sinus rhythm (n = 48).However, only 28.3% (n = 269) had a therapeutic international normalized ratio. Among 1825 women of childbearing age (12-51 years), only 3.6% (n = 65) were on contraception. The utilization of valvuloplasty and valve surgery was higher in upper-middle compared with lower-income countries. Conclusion Rheumatic heart disease patients were young, predominantly female, and had high prevalence of major cardiovascular complications. There is suboptimal utilization of secondary antibiotic prophylaxis, oral anti-coagulation, and contraception, and variations in the use of percutaneous and surgical interventions by country income level. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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