Clinical Characteristics, Complications, and Treatment Practices in Patients With RHD: 6-Year Results From HP-RHD...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Rheumatic heart disease (RHD) is prevalent in developing nations, yet comprehensive data on its characteristics, complications, and treatment in India is scarce.
• The Himachal Pradesh Rheumatic Heart Disease (HP-RHD) registry was established to address this data gap in northern India.

Purpose of the Study:

• To characterize RHD patients in northern India.
• To identify complications and assess treatment practices for RHD.
• To analyze risk factors for adverse cardiovascular events in RHD patients.

Main Methods:

• A registry of 2,005 consecutive RHD patients was compiled over six years (2011-2016).
• Systematic recording of clinical characteristics, complications, and treatment modalities was performed.
• Statistical analysis identified independent risk determinants for major adverse cardiovascular events.

Main Results:

• RHD primarily affected females (72.3%) and rural populations (92%), with a mean age of 40.3 years.
• Multivalvular involvement (43.2%) and moderate-to-severe valvular dysfunction (69.3%) were common; mitral valve was most affected (83.3%).
• Major adverse cardiovascular events occurred in 23.4%, including heart failure (15.6%), peripheral embolism (4.1%), and stroke (3.9%). Advanced age, severe mitral stenosis, severe tricuspid regurgitation, pulmonary artery hypertension, and atrial fibrillation were independent risk factors.

Conclusions:

• RHD complications escalate with patient age and the severity of valvular dysfunction.
• Effective management strategies require early detection and adherence to evidence-based treatment protocols.
• Improved outcomes for RHD patients depend on targeted interventions and secondary prophylaxis programs.