Rheumatic heart disease and risk of incident heart failure among community-dwelling older adults: a prospective cohort study.
Ann Med
; 44(3): 253-61, 2012 May.
Article
en En
| MEDLINE
| ID: mdl-21254894
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 1.13-2.28; 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 (1.54-2.71; P < 0.001), 1.32 (1.02-1.70; P = 0.034), and 1.55 (1.14-2.11; P = 0.005), respectively. RHD was not associated with all-cause mortality (HR 1.09; 95% CI 0.82-1.45; 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.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Cardiopatía Reumática
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Insuficiencia Cardíaca
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Ann Med
Asunto de la revista:
MEDICINA
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos