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Shifts in Clinical Characteristics, Treatment, and Outcome for Rheumatic Mitral Stenosis: Insights From a 20-Year Multicentre Registry Study in Korea

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Author(s)
Hee Jeong LeeIksung ChoDae-Young KimJang-Won SonKang-Un ChoiSeonhwa LeeIn-Cheol KimKyu-Yong KoKyung Eun HaSeo-Yeon GwakKyu KimJiwon SeoHojeong KimChi Young ShimJong-Won HaHyungseop KimGeu-Ru HongJagat Narula
Keimyung Author(s)
Lee, Hee JungLee, Seon hwaKim, In CheolKim, Hyung Seop
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Korean Med Sci
Issued Date
2024
Volume
39
Issue
17
Keyword
Trend ChangeRheumatic Mitral StenosisRheumatic Heart DiseaseKorea
Abstract
Background:
The rapid economic development of South Korea provides a unique model to study changes in the clinical characteristics, treatment approaches, and clinical outcomes of patients with rheumatic mitral stenosis (MS) relative to socioeconomic growth.

Methods:
From the Multicenter mitrAl STEnosis with Rheumatic etiology (MASTER) registry, 2,337 patients diagnosed with moderate or severe rheumatic MS between January 2001 and December 2020 were analyzed. Patients were grouped into consecutive 5-year intervals based on their year of diagnosis. Clinical characteristics, echocardiographic data, and clinical outcomes were assessed.

Results:
Over 20 years, the severity of mitral stenosis increased from 79.1% to 90.2%; similarly, the average age at diagnosis increased from 54.3 to 63.0 years (all P < 0.001). Comorbidities such as hypertension and atrial fibrillation increased (6.3% to 29.5% and 41.4% to 46.9%, respectively; all P for trend < 0.05). The rate of mitral intervention within five years after diagnosis increased from 31.2% to 47.4% (P for trend < 0.001). However, clinical outcomes of rheumatic mitral stenosis deteriorated over time in the composite outcomes (log-rank test, P < 0.001). Conversely, the incidence of stroke remained stable (60.6–73.7%; P < 0.001), which might be attributed to the increased use of anticoagulation therapy.

Conclusion:
This study observed an increase in patient age, comorbidities, and valve disease severity as the country transitioned from a developing to developed status. Despite a rise in mitral valve interventions, clinical outcomes deteriorated over 20 years, highlighting the need for modified treatment approaches to improve patient outcomes.
Keimyung Author(s)(Kor)
이희정
이선화
김인철
김형섭
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1598-6357
Source
https://jkms.org/DOIx.php?id=10.3346/jkms.2024.39.e152
DOI
10.3346/jkms.2024.39.e152
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45393
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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