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New research · Rheumatology
Acta cardiologica · 21h
Cohort studyActa cardiologica · 2026

Intramuscular penicillin prophylaxis and valve progression in adults with mild rheumatic heart disease: a propensity score-matched cohort study.

Ayse Huseyinoglu Aydin, Fatih Aydın
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RheumatologyCohort study

Penicillin prophylaxis was not linked to less valve progression or new disease in adults.

Intramuscular penicillin prophylaxis and valve progression in adults with mild rheumatic heart disease: a propensity score-matched cohort study.

Ayse Huseyinoglu Aydin, Fatih Aydın
Acta cardiologica · 2026
Background

Evidence supporting intramuscular penicillin prophylaxis in rheumatic heart disease (rheumatic heart disease) is largely derived from paediatric populations, and its role in adults with mild disease remains unclear.

Purpose

We aimed to evaluate its impact on valve progression in adults with early-stage rheumatic heart disease.

Methods

This retrospective cohort study included 312 adults with World Heart Federation (World Heart Federation) Stage A or B rheumatic heart disease.

n = 312 adults
Results

Odds of valve progression or new valve disease were similar with prophylaxis.

RR by subgroup · 95% CI
null = 1
prophylaxis
0.84
respectively
1.27
3% of the prophylaxis
1.06
More results

Valve progression occurred in 2.0% of patients without prophylaxis and in 1.7% of patients with prophylaxis (RR 0.84; 95% CI 0.16-4.54; p = 1.000).

New valve disease developed in 2.0% and 2.6% of patients, respectively (RR 1.27; 95% CI 0.29-5.56; p = 0.714).

More results

The composite outcome occurred in 4.1% of the no-prophylaxis group and 4.3% of the prophylaxis group (RR 1.06; 95% CI 0.35-3.15; p = 1.000).

“
Conclusion · 1 of 2

In adults with mild rheumatic heart disease, intramuscular penicillin prophylaxis was not associated with reduced valve progression or new valve disease.

Conclusion · 2 of 2

Careful clinical and echocardiographic follow-up may be a reasonable strategy in selected patients.

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