Outcomes and care quality metrics for people living with rheumatic heart disease and atrial fibrillation in Uganda.

Atrial fibrillation Global health Outcomes Retention in care Rheumatic heart disease

Journal

Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511

Informations de publication

Date de publication:
Apr 2024
Historique:
medline: 1 5 2024
pubmed: 1 5 2024
entrez: 1 5 2024
Statut: epublish

Résumé

Atrial fibrillation (AF) is a common complication of rheumatic heart disease (RHD) and is challenging to treat in lower-resourced settings in which RHD remains endemic. We characterized demographics, treatment outcomes, and factors leading to care retention for participants with RHD and AF in Uganda. We conducted a retrospective analysis of the Uganda national RHD registry between June 2009 and May 2018. Participants with AF or atrial flutter were included. Demographics, survival, and care metrics were compared with participants without AF. Multivariable logistic regression was used to identify factors associated with retention in care among participants with AF. A total of 1530 participants with RHD were analyzed and 293 (19%) had AF. The median age was 24 (interquartile range 14-38) years. Mortality was similar in both groups (adjusted hazard ratio 1.183, Participants with RHD and AF in Uganda do not experience higher mortality than those without AF. Anticoagulation prescription rates are high. Although retention in care is poor among RHD participants, those with concurrent AF are more likely to be retained.

Sections du résumé

Background UNASSIGNED
Atrial fibrillation (AF) is a common complication of rheumatic heart disease (RHD) and is challenging to treat in lower-resourced settings in which RHD remains endemic.
Objective UNASSIGNED
We characterized demographics, treatment outcomes, and factors leading to care retention for participants with RHD and AF in Uganda.
Methods UNASSIGNED
We conducted a retrospective analysis of the Uganda national RHD registry between June 2009 and May 2018. Participants with AF or atrial flutter were included. Demographics, survival, and care metrics were compared with participants without AF. Multivariable logistic regression was used to identify factors associated with retention in care among participants with AF.
Results UNASSIGNED
A total of 1530 participants with RHD were analyzed and 293 (19%) had AF. The median age was 24 (interquartile range 14-38) years. Mortality was similar in both groups (adjusted hazard ratio 1.183,
Conclusion UNASSIGNED
Participants with RHD and AF in Uganda do not experience higher mortality than those without AF. Anticoagulation prescription rates are high. Although retention in care is poor among RHD participants, those with concurrent AF are more likely to be retained.

Identifiants

pubmed: 38690140
doi: 10.1016/j.hroo.2024.02.002
pii: S2666-5018(24)00028-X
pmc: PMC11056452
doi:

Types de publication

Journal Article

Langues

eng

Pagination

201-208

Informations de copyright

© 2024 Heart Rhythm Society. Published by Elsevier Inc.

Auteurs

Chinonso C Opara (CC)

Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington.

Roy H Lan (RH)

Department of Medicine, Stanford University School of Medicine, California.

Joselyn Rwebembera (J)

Department of RHD Research, Uganda Heart Institute, Kampala, Uganda.

Emmy Okello (E)

Division of Cardiology, Uganda Heart Institute, Kampala, Uganda.

David A Watkins (DA)

Department of Medicine, University of Washington, Seattle, Washington.
Department of Global Health, University of Washington, Seattle, Washington.

Andrew Y Chang (AY)

Division of Cardiology, Department of Epidemiology and Population Health, Stanford University, California.
Center for Innovation in Global Health, Stanford University, Stanford, California.
Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California.

Chris T Longenecker (CT)

Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington.
Department of Global Health, University of Washington, Seattle, Washington.

Classifications MeSH