Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study).
| Title: | Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study). |
|---|---|
| Authors: | Zühlke L; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa Division of Paediatric Cardiology, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa.; Engel ME; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa.; Karthikeyan G; Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.; Rangarajan S; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.; Mackie P; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.; Cupido B; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa.; Mauff K; Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa.; Islam S; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.; Joachim A; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa.; Daniels R; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa.; Francis V; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa.; Ogendo S; Department of Surgery, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya.; Gitura B; Cardiology Unit, Department of Medicine, Kenyatta National Teaching and Referral Hospital, Nairobi, Kenya.; Mondo C; Cardiology Unit, Department of Medicine, Mulago Hospital, Kampala, Uganda.; Okello E; Uganda Heart Institute, Kampala, Uganda.; Lwabi P; Uganda Heart Institute, Kampala, Uganda.; Al-Kebsi MM; Faculty of Medicine and Surgery, University of Sana'a, Al-Thawrah Cardiac Center, Sana'a, Yemen.; Hugo-Hamman C; Division of Paediatric Cardiology, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa Paediatric Cardiology Service, Windhoek Central Hospital, Windhoek, Namibia.; Sheta SS; Department of Paediatrics, Division of Paediatric Cardiology, Faculty of Medicine, Cairo University Children's Hospital, Cairo, Egypt.; Haileamlak A; Department of Paediatrics and Child Health, Jimma University Hospital, Jimma, Ethiopia.; Daniel W; Department of Paediatrics and Child Health, Jimma University Hospital, Jimma, Ethiopia.; Goshu DY; Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.; Abdissa SG; Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.; Desta AG; Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.; Shasho BA; Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.; Begna DM; Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.; ElSayed A; Department of Cardiothoracic Surgery, Al Shaab Teaching Hospital, Faculty of Medicine, Alzaiem Alazhari University, Khartoum, Sudan.; Ibrahim AS; Department of Cardiothoracic Surgery, Al Shaab Teaching Hospital, Faculty of Medicine, Alzaiem Alazhari University, Khartoum, Sudan.; Musuku J; Department of Paediatrics and Child Health, University Teaching Hospital, University of Zambia, Lusaka, Zambia.; Bode-Thomas F; Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria.; Okeahialam BN; Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria.; Ige O; Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria.; Sutton C; Department of Paediatrics and Child Health, University of Limpopo, Polokwane, South Africa.; Misra R; Department of Internal Medicine, University of Limpopo, Polokwane, South Africa.; Abul Fadl A; Faculty of Medicine, Benha University, Cairo, Egypt.; Kennedy N; Department of Paediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi.; Damasceno A; Department of Cardiology, Eduardo Mondlane University, Maputo, Mozambique.; Sani M; Department of Medicine, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria.; Ogah OS; Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria Nigeria Ministry of Health, Umuahia, Abia State, Nigeria Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.; Olunuga T; Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.; Elhassan HH; Ahmed Gasim Teaching Hospital, Khartoum, Sudan.; Mocumbi AO; Instituto Nacional de Saúde and Eduardo Mondlane University, Maputo, Mozambique.; Adeoye AM; Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria.; Mntla P; Department of Cardiology, Dr. George Mukhari Hospital and University of Limpopo (MEDUNSA Campus), Tshwane, South Africa.; Ojji D; Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria.; Mucumbitsi J; Paediatric Cardiology Unit, Department of Paediatrics, King Faisal Hospital, Kigali, Rwanda.; Teo K; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.; Yusuf S; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.; Mayosi BM; The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, J Floor Old Groote Schuur Hospital, Groote Schuur Drive, Observatory 7925, Cape Town, South Africa bongani.mayosi@uct.ac.za. |
| Source: | European heart journal [Eur Heart J] 2015 May 07; Vol. 36 (18), pp. 1115-22a. Date of Electronic Publication: 2014 Nov 25. |
| Publication Type: | Journal Article; Multicenter Study; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 8006263 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-9645 (Electronic) Linking ISSN: 0195668X NLM ISO Abbreviation: Eur Heart J Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2005- : Oxford : Oxford University Press; Original Publication: London, Saunders [etc.] |
| MeSH Terms: | Rheumatic Heart Disease/*therapy; Anti-Bacterial Agents/therapeutic use ; Anticoagulants/administration & dosage ; Heart Valve Diseases/epidemiology ; Heart Valve Diseases/etiology ; Heart Valve Diseases/therapy ; Penicillins/therapeutic use ; Rheumatic Heart Disease/complications ; Rheumatic Heart Disease/epidemiology ; Administration, Oral ; Adult ; Age Distribution ; Antibiotic Prophylaxis ; Cross-Sectional Studies ; Developing Countries ; Evidence-Based Medicine ; Female ; Global Health ; Humans ; Male ; Pilot Projects ; Prospective Studies ; Sex Distribution |
| Abstract: | 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 anti-coagulants were 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.; (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.) |
| Comments: | Comment in: Eur Heart J. 2015 May 7;36(18):1070-3. doi: 10.1093/eurheartj/ehu507.. (PMID: 25583760) |
| References: | N Engl J Med. 2007 Nov 15;357(20):2088; author reply 2088-9. (PMID: 18003968); Nat Rev Cardiol. 2013 May;10(5):284-92. (PMID: 23546444); Arch Cardiovasc Dis. 2011 Jun-Jul;104(6-7):370-4. (PMID: 21798468); Am J Cardiol. 2010 Jun 15;105(12):1809-14. (PMID: 20538135); Lancet Infect Dis. 2005 Nov;5(11):685-94. (PMID: 16253886); QJM. 2003 Mar;96(3):217-25. (PMID: 12615986); S Afr Med J. 1987 Dec 5;72(11):781-3. (PMID: 3686281); Circulation. 2014 Apr 15;129(15):1568-76. (PMID: 24463370); Jpn Heart J. 1976 Sep;17(5):550-9. (PMID: 994335); Intern Med J. 2013 Apr;43(4):386-93. (PMID: 22646671); Circulation. 2009 Sep 22;120(12):1029-35, 2 p following 1035. (PMID: 19738136); Heart. 2006 Oct;92(10):1520-5. (PMID: 16973809); Circulation. 2013 Jul 30;128(5):492-501. (PMID: 23794730); Cardiovasc J S Afr. 2006 Jul-Aug;17(4):164-5. (PMID: 17001417); Lancet. 2012 Dec 15;380(9859):2197-223. (PMID: 23245608); Heart. 2013 Nov;99(21):1554-61. (PMID: 23680886); Circulation. 1998 Sep 8;98(10):946-52. (PMID: 9737513); Cardiovasc J Afr. 2007 Sep-Oct;18(5):295-9. (PMID: 17957324); Cardiovasc Diagn Ther. 2013 Dec;3(4):236-43. (PMID: 24400207); S Afr Med J. 2003 Mar;93(3):212-8. (PMID: 12768947); Heart. 2012 Mar;98(6):450-5. (PMID: 22350029); Cardiovasc J Afr. 2008 May-Jun;19(3):135-40. (PMID: 18568172); Am Heart J. 2012 Apr;163(4):535-40.e1. (PMID: 22520517); Lancet. 2014 Mar 15;383(9921):955-62. (PMID: 24315724); Turk Kardiyol Dern Ars. 2013 Jan;41(1):1-10. (PMID: 23518931); BMC Cardiovasc Disord. 2012;12:23. (PMID: 22463484); Eur Heart J. 2010 Mar;31(6):719-27. (PMID: 19995873); Circulation. 2008 Dec 16;118(25):2748-53. (PMID: 19106399); East Mediterr Health J. 2000 Mar-May;6(2-3):437-46. (PMID: 11556035); Circ J. 2014;78(6):1342-8. (PMID: 24717234); Pediatr Rheumatol Online J. 2010 Jul 26;8:22. (PMID: 20659324); Circulation. 2014 Jun 10;129(23):2440-92. (PMID: 24589852); Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78. (PMID: 11816692) |
| Grant Information: | United Kingdom Wellcome Trust |
| Contributed Indexing: | Keywords: Atrial fibrillation; Congestive heart failure; Infective endocarditis; Rheumatic heart disease; Stroke; Valve surgery; Valvuloplasty |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents); 0 (Anticoagulants); 0 (Penicillins) |
| Entry Date(s): | Date Created: 20141127 Date Completed: 20160201 Latest Revision: 20220410 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4422972 |
| DOI: | 10.1093/eurheartj/ehu449 |
| PMID: | 25425448 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't