CARDIOVASCULAR experts from South Africa and Canada will conduct the largest global study of patients with rheumatic heart disease (RHD) – which kills about 233 000 people per year, despite the disease being preventable.
The worldwide programme, called Invictus, consists of a registry of 20 000 patients and two clinical trials that will examine if an oral anticoagulant, rivaroxaban, can safely reduce strokes in patients with RHD.
Announced at the World Congress of Cardiology and Cardiovascular Health, which concluded in Mexico this week, researchers from UCT and the Population Health Research Institute at McMaster University in Canada, along with the World Heart Federation, are now calling on cardiovascular experts from around the world to join the project.
The global burden of RHD, which is caused by rheumatic fever after an untreated strep throat infection, currently falls disproportionately on children and young adults living in the developing world, especially where poverty is widespread, like sub-Saharan Africa, India and other parts of Asia.
UCT professor and head of the department of medicine at Groote Schuur Hospital, and also a lead investigator for Invictus, Bongani Mayosi, said: “RHD with atrial fibrillation is a major cause of stroke, disability and death in children and young adults living in developing countries.
“Warfarin (used to prevent the formation of blood clots) is the only effective preventive drug at the moment, but is notoriously difficult to use safely in many parts of the world.”
He said Invictus would provide definitive information on the effectiveness and safety of the oral Factor Xa inhibitor Xarelto® (rivaroxaban), which was much easier to use than Warfarin and less likely to cause fatal bleeding complications.
World Heart Federation president and chairperson of the steering committee for Invictus, Salim Yusuf, said the launch of the RHD patient registry and trial programme on such a global scale formed a key part of the international efforts under way to reduce RHD mortality rates.
Professor Stuart Connolly, from McMaster University and an Invictus co-lead investigator, said the direct oral anticoagulants such as rivaroxaban had been shown in large clinical trials to be safe and effective in patients with non-valvular atrial fibrillation in developed countries, but RHD patients were excluded from those trials.