A recent study found that nearly 15% of patients with rheumatic heart disease in low- and middle-income countries died within 3 years, primarily due to heart failure or sudden death.
Significant mortality rates associated with rheumatic heart disease (RHD) in low- and middle-income countries (LMICs) were reported. The study, published in JAMA, involved 13,696 patients from 24 RHD-endemic countries.
The study analyzed clinical outcomes over a median follow-up of 3.2 years. Findings indicated that corrective valve surgery or valvuloplasty was independently associated with a reduced risk of death, yet only about 4.4% of patients underwent these procedures.
Key predictors of increased mortality included congestive heart failure, pulmonary hypertension, and atrial fibrillation. Improved access to surgical and interventional treatments was associated with reduced mortality. Additionally, higher country income levels correlated with lower mortality rates after adjusting for patient-level factors, suggesting disparities in healthcare access.
The study emphasizes the importance of surgical care availability for RHD patients in LMICs. Secondary antibiotic prophylaxis was associated with lower mortality among younger patients, suggesting potential benefits for integrated management approaches for RHD.
Most deaths among RHD patients were attributed to heart failure or sudden death.
Full disclosures can be found in the original study.