Valvular & structural heart diseaseCohort study
Mortality and Morbidity in Adults With Rheumatic Heart Disease
- Prospective cohort study
- multicentre
- hospital-based
- prospective observational
- Enrolment August 2016 to May 2022
Authors' conclusion
Mortality in RHD is high and is correlated with the severity of valve disease. Valve surgery and valvuloplasty were associated with substantially lower mortality.
Study context
- Population
- Patients with clinical rheumatic heart disease at 138 sites in 24 rheumatic heart disease (RHD)-endemic low- and middle-income countries12,967 with vital status
- Participants
- 13,696 patients
- Outcome
- All-cause mortality
- Follow-up
- Median 3.2 years
Main finding
As reported in the abstract
median 3.2 years (41 478 patient-years)
- Deaths
- 1943 (15% overall; 4.7% per patient-year)
- Congestive heart failure (HF), HR
- 1.58 (95% CI 1.50-1.87; P < .001)
- Pulmonary hypertension, HR
- 1.52 (95% CI 1.37-1.69; P < .001)
- AF, HR
- 1.30 (95% CI 1.15-1.46; P < .001)
- Surgery, HR
- 0.23 (95% CI 0.12-0.44; P < .001)
- Valvuloplasty, HR
- 0.24 (95% CI 0.06-0.95; P = .042)
Observational data: associations, not effects.
Secondary outcomes
Cause of death
- Vascular causes (mainly HF or SCD)
- 1312 [67.5%]
Valve surgery, HF hospitalization, stroke, recurrent rheumatic fever
- Valve surgery
- 604 [4.4%]
- HF hospitalization
- 2% per year
- Stroke
- 0.6% per year
- Recurrent rheumatic fever rare
Original publication
Mortality and Morbidity in Adults With Rheumatic Heart Disease. JAMA. Published 9 July 2024. doi:10.1001/jama.2024.8258
Summarised from the published abstract; every number is checked against it