{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:26:09Z","timestamp":1784280369135,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["#114652"],"award-info":[{"award-number":["#114652"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"End -RHD Centre for Research Excellence and HeartKids"},{"name":"NHMRC Postgraduate Scholarship","award":["#2005398"],"award-info":[{"award-number":["#2005398"]}]},{"name":"Ad Hoc Postgraduate Scholarship at the University of Western Australia"},{"name":"Heart Foundation Future Leader Fellowship","award":["#102043"],"award-info":[{"award-number":["#102043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\u2003<\/jats:title><jats:p>Rheumatic heart disease (RHD) is a major contributor to cardiac morbidity and mortality globally. This study aims to estimate the probability and predictors of progressing to non-fatal cardiovascular complications and death in young Australians after their first RHD diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results\u2003<\/jats:title><jats:p>This retrospective cohort study used linked RHD register, hospital, and death data from five Australian states and territories (covering 70% of the whole population and 86% of the Indigenous population). Progression from uncomplicated RHD to all-cause death and non-fatal cardiovascular complications (surgical intervention, heart failure, atrial fibrillation, infective endocarditis, and stroke) was estimated for people aged &amp;lt;35 years with first-ever RHD diagnosis between 2010 and 2018, identified from register and hospital data. The study cohort comprised 1718 initially uncomplicated RHD cases (84.6% Indigenous; 10.9% migrant; 63.2% women; 40.3% aged 5\u201314 years; 76.4% non-metropolitan). The composite outcome of death\/cardiovascular complication was experienced by 23.3% (95% confidence interval: 19.5\u201326.9) within 8 years. Older age and metropolitan residence were independent positive predictors of the composite outcome; history of acute rheumatic fever was a negative predictor. Population group (Indigenous\/migrant\/other Australian) and sex were not predictive of outcome after multivariable adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion\u2003<\/jats:title><jats:p>This study provides the most definitive and contemporary estimates of progression to major cardiovascular complication or death in young Australians with RHD. Despite access to the publically funded universal Australian healthcare system, one-fifth of initially uncomplicated RHD cases will experience one of the major complications of RHD within 8 years supporting the need for programmes to eradicate RHD.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjopen\/oeab035","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T13:04:19Z","timestamp":1636463059000},"source":"Crossref","is-referenced-by-count":27,"title":["Long-term outcomes following rheumatic heart disease diagnosis in Australia"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-6031","authenticated-orcid":false,"given":"Ingrid","family":"Stacey","sequence":"first","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4468-6097","authenticated-orcid":false,"given":"Joseph","family":"Hung","sequence":"additional","affiliation":[{"name":"Medical School, University of Western Australia , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1321-9605","authenticated-orcid":false,"given":"Jeff","family":"Cannon","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, Australia"},{"name":"Harvard T.H. Chan School of Public Health , Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-6205","authenticated-orcid":false,"given":"Rebecca J","family":"Seth","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Remenyi","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University , Darwin, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bond-Smith","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, Australia"},{"name":"University of Hawai\u2019i Economic Research Organisation, University of Hawai\u2019i , Honolulu, HI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-3439","authenticated-orcid":false,"given":"Kalinda","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research, Charles Darwin University , Darwin, Australia"},{"name":"Centre for Big Data Research, The University of New South Wales , Sydney, Australia"},{"name":"Centre for Health Equity, University of Melbourne , Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3639-0787","authenticated-orcid":false,"given":"Frank","family":"Sanfilippo","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Carapetis","sequence":"additional","affiliation":[{"name":"Telethon Kids Institute, University of Western Australia , Perth, Australia"},{"name":"Perth Children\u2019s Hospital , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8856-6046","authenticated-orcid":false,"given":"Kevin","family":"Murray","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5287-5819","authenticated-orcid":false,"given":"Judith M","family":"Katzenellenbogen","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Clifton St Building, Clifton St, University of Western Australia , Perth, 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