Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

Abstract

BackgroundThe aim of the present study was to identify the long-term major adverse cardiovascular events (MACE) in adult congenital heart disease (ConHD) patients in Taiwan.MethodsFrom the National Health Insurance Research Database (1997-2010), adult patients (≥18 years) with ConHD were identified and compared to non-ConHD control patients. The primary end point was the incidence of MACE. Cox proportional hazards models were used to compute hazard ratios as estimates for multivariate adjusted relative risks with or without adjusting for age and sex.ResultsA total of 3,267 adult patients with ConHD were identified between 2000 and 2003 with a median follow-up of 11 years till December 31, 2010. The five most common types of ConHD were atrial septal defects, ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, and pulmonary stenosis. Overall, the incidence of MACE was 4.0-fold higher in the ConHD group compared with the controls. After adjustment for age and gender, the patients with ConHD had an increased risk of heart failure, malignant dysrhythmia, acute coronary syndrome, and stroke. The adult ConHD patients had a decreased life-long risk of MACE if they received surgical correction, especially in the patients with atrial septal defects.ConclusionsAfter a median of 11 years of follow-up, the Taiwanese patients with ConHD were at an increased risk of life-long cardiovascular MACE, including heart failure, stroke, acute coronary syndrome, and malignant dysrhythmia. Surgical correction may help to decrease long-term MACE in ConHD patients, especially those with ASD.

Long-Term Nationwide Follow-Up Study of Simple Congenital Heart Disease Diagnosed in Otherwise Healthy Children

“…with the development of heart failure and ventricular tachyarrhythmias. The relative risk of critical cardiac morbidity in our cohort was comparable with a recent study 35 describing an aHR of 3.8 (95% CI, 3.3-4.4) of major adverse cardiac events among noncyanotic CHD patients. Our figures concerning ventricular tachycardia was also in accordance with the result from the Euro Heart Survey, 22 which revealed a prevalence of ventricular tachycardia of 2.3% in patients with simple CHD.…”

Risk of Systemic Hypertension and Cerebrovascular Accident in Patients With Aortic Coarctation Aged <60 Years (from a National Database Study)

“…In a recent study of 3,267 adult CHD patients, the risk of developing CVA was 2.2 times higher for the subjects with CHD than for those without CHD. 21 In the present study, we further demonstrated that in CHD patients CoA is a strong risk factor for CVA. CoA patients are at > 5 folds of risk to develop CVA as compared to non-CoA patients.…”

Adolescents and Adults with Congenital Heart Diseases in Oman

“…Furthermore, we found that patients with ventricular septal defect had shorter survival time compared to patients with atrial septal defect, and this could be due to the fact that patients with unrepaired ventricular septal defects are at high risk of infective endocarditis 10 and pulmonary hypertension if left untreated. 26,27 As our data represent a single center experience, some patients may have presented to other regional hospitals with complications and died or lost to follow-up there. Interruption of followup, arrhythmias, sudden death, and infective endocarditis have been well described in this population.…”