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INTRODUCTION: Rheumatic mitral stenosis continues to be prevalent in developing countries, notably in endemic areas. Over the last few decades, percutaneous balloon mitral valvuloplasty (PBMV) has been established as a lower-cost alternative treatment for mitral stenosis (MS) in low-to-middle-income countries. PBMV has also been suggested to be an effective and safe alternative treatment modality. This study aims to analyse the survival of rheumatic MS patients treated with PBMV compared with those treated with mitral valve surgery (MVS). METHODS: This study was a national, single-centre, longitudinal study using a survival analysis method in 329 consecutive patients suffering from rheumatic heart disease with severe MS who underwent PBMV compared with 142 consecutive patients with similar characteristics who underwent MVS between January 2011 and December 2016. Survival analysis and event-free duration were determined over a median follow-up of 24 months in the PBMV group and 27 months in the MVS group. RESULTS: The results showed that of the 329 consecutive patients in the PBMV group, 61 patients (18.5) had an event (6 patients died and 55 patients were hospitalised), and of the 142 consecutive patients in the MVS group, 19 patients (13.4%) had an event (5 patients died, and 14 patients were hospitalised). The hazard ratio was 0.631 (95% confidence interval, 0.376-1.058; Pâ¯= 0.081). Longer short-term survival was found in the MVS group but was not statistically significant. Event-free survival was significantly longer in the MVS group (Pâ¯= 0.002), by 5 months. CONCLUSIONS: In this study, the efficacy and safety of PBMV was reconfirmed, as PBMV proved to be non-inferior to MVS in survival prognosis, but sustained event-free duration was significantly better in the MVS group than in the PBMV group.
RESUMEN
To contribute information on coronary heart disease and its risk factors (information which is still scarce in developing countries), this report is presented on a population screening study done in urban Jakarta, using the MONICA Protocol. A randomly selected sample of 2073 people (25-64 years) from 3 districts (total population 523,000) of Jakarta were examined. The results were as follows: electrocardiogram (ECG) signs of old myocardial infarction were found in 2.7%, and sequelae of stroke in 0.5% of respondents: prevalence of hypertension was found in 14.9%; male smokers were 59.9% (females only 5.9%); mean serum total cholesterol concentrations were 5.2 mmol/L in men and 5.4 mmol/L in women, with 13.4% of all respondents having hypercholesterolaemia (greater than or equal to 6.5 mmol/L); regular alcohol drinkers were only 2.7%. Anti-smoking, anti-hypertension and active physical exercise campaigns already launched many years ago will be boosted, along with the preservation of the traditional low fat diet of the common Indonesian.