Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the global rheumatic heart disease registry (the remedy study).
dc.contributor.author | Zühlke, L | |
dc.contributor.author | Engel, ME | |
dc.contributor.author | Karthikeyan, G | |
dc.contributor.author | Rangarajan, S | |
dc.contributor.author | Mackie, P | |
dc.contributor.author | Cupido, B | |
dc.contributor.author | Mauff, K | |
dc.contributor.author | Islam, S | |
dc.contributor.author | Joachim, A | |
dc.contributor.author | Daniels, R | |
dc.contributor.author | Francis, V | |
dc.contributor.author | Ogendo, S | |
dc.contributor.author | Gitura, B | |
dc.contributor.author | Mondo, C | |
dc.contributor.author | Okello, E | |
dc.contributor.author | Lwabi, P | |
dc.contributor.author | Al-Kebsi, MM | |
dc.contributor.author | Hugo-Hamman, C | |
dc.contributor.author | Sheta, SS | |
dc.contributor.author | Haileamlak, A | |
dc.contributor.author | Daniel, W | |
dc.contributor.author | Goshu, DY | |
dc.contributor.author | Abdissa, SG | |
dc.contributor.author | Desta, AG | |
dc.contributor.author | Shasho, BA | |
dc.contributor.author | Begna, DM | |
dc.contributor.author | ElSayed, A | |
dc.contributor.author | Ibrahim, AS | |
dc.contributor.author | Musuku, J | |
dc.contributor.author | Bode-Thomas, F | |
dc.contributor.author | Okeahialam, BN | |
dc.contributor.author | Ige, O | |
dc.contributor.author | Sutton, C | |
dc.contributor.author | Misra, R | |
dc.contributor.author | Abul, Fadl A | |
dc.contributor.author | Kennedy, N | |
dc.contributor.author | Damasceno, A | |
dc.contributor.author | Sani, M | |
dc.contributor.author | Ogah, OS | |
dc.contributor.author | Olunuga, T | |
dc.contributor.author | Elhassan, HH | |
dc.contributor.author | Mocumbi, AO | |
dc.contributor.author | Adeoye, AM | |
dc.contributor.author | Mntla, P | |
dc.contributor.author | Ojji, D | |
dc.contributor.author | Mucumbitsi, J | |
dc.contributor.author | Teo, K | |
dc.contributor.author | Yusuf, S | |
dc.contributor.author | Mayosi, BM | |
dc.date.accessioned | 2014-12-17T13:49:03Z | |
dc.date.available | 2014-12-17T13:49:03Z | |
dc.date.issued | 2014 | |
dc.identifier.uri | http://hdl.handle.net/11295/77820 | |
dc.description.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. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.title | Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the global rheumatic heart disease registry (the remedy study). | en_US |
dc.type | Article | en_US |
dc.type.material | en | en_US |
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