Rheumatic heart disease and risk of incident heart failure among community-dwelling older adults: A prospective cohort study

Marjan Mujib, Ravi V. Desai, Mustafa I. Ahmed, Jason L. Guichard, Margaret A. Feller, O. James Ekundayo, Prakash Deedwania, Mahboob Ali, Inmaculada B. Aban, Thomas E. Love, Michel White, Wilbert S. Aronow, Shahbudin H. Rahimtoola, Robert O Bonow, Ali Ahmed*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Background. Little is known about the association of rheumatic heart disease (RHD) with incident heart failure (HF) among older adults. Design. Cardiovascular Health Study, a prospective cohort study. Methods. Of the 4,751 community-dwelling adults ≥ 65 years, free of prevalent HF at baseline, 140 had RHD, defined as self-reported physician-diagnosed RHD along with echocardiographic evidence of left-sided valvular disease. Propensity scores for RHD, estimated for each of the 4,751 participants, were used to assemble a cohort of 720, in which 124 and 596 participants with and without RHD, respectively, were balanced on 62 baseline characteristics. Results. Incident HF developed in 33% and 22% of matched participants with and without RHD, respectively, during 13 years of follow-up (hazard ratio when RHD was compared to no-RHD 1.60; 95% confidence interval 1.132.28; P = 0.008). Pre-match unadjusted, multivariable-adjusted, and propensity-adjusted hazard ratios (95% confidence intervals) for RHD-associated incident heart failure were 2.04 (1.542.71; P < 0.001), 1.32 (1.021.70; P = 0.034), and 1.55 (1.142.11; P = 0.005), respectively. RHD was not associated with all-cause mortality (HR 1.09; 95% CI 0.821.45; P = 0.568). Conclusion. RHD is an independent risk factor for incident HF among community-dwelling older adults free of HF, but has no association with mortality.

Original languageEnglish (US)
Pages (from-to)253-261
Number of pages9
JournalAnnals of Medicine
Volume44
Issue number3
DOIs
StatePublished - May 1 2012

Keywords

  • Heart failure
  • Older adults
  • Rheumatic heart disease

ASJC Scopus subject areas

  • Medicine(all)

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