TY - JOUR
T1 - Rheumatic heart disease and risk of incident heart failure among community-dwelling older adults
T2 - A prospective cohort study
AU - Mujib, Marjan
AU - Desai, Ravi V.
AU - Ahmed, Mustafa I.
AU - Guichard, Jason L.
AU - Feller, Margaret A.
AU - Ekundayo, O. James
AU - Deedwania, Prakash
AU - Ali, Mahboob
AU - Aban, Inmaculada B.
AU - Love, Thomas E.
AU - White, Michel
AU - Aronow, Wilbert S.
AU - Rahimtoola, Shahbudin H.
AU - Bonow, Robert O.
AU - Ahmed, Ali
N1 - Funding Information:
Declaration of interest: A. Ahmed is supported by
PY - 2012/5
Y1 - 2012/5
N2 - 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.
AB - 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.
KW - Heart failure
KW - Older adults
KW - Rheumatic heart disease
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U2 - 10.3109/07853890.2010.530685
DO - 10.3109/07853890.2010.530685
M3 - Review article
C2 - 21254894
AN - SCOPUS:84859312795
SN - 0785-3890
VL - 44
SP - 253
EP - 261
JO - Annals of Medicine
JF - Annals of Medicine
IS - 3
ER -
