Author + information
- Mette Glavind Bülow Pedersena,b,
- Morten Olsena,b,
- Morten Schmidta,b,
- Henning B. Laursena,b,
- Søren Johnsena,b and
- Nicolas Madsena,b
Background: Congenital heart disease (CHD) is associated with known risk factors for stroke such as cardiac arrhythmias and heart failure. The incidence and mortality of stroke in adults with CHD remains incompletely understood.
Methods: Using population-based Danish nationwide registries, we identified all individuals diagnosed with CHD between 1963 and 2012. Patients were included if alive and living in Denmark at the minimum age of 30 years. Using the Danish Civil Registration system, we created a general population comparison cohort by matching 10 individuals to each CHD subject on sex and birth year. Follow-up started at the age of 30 years and continued until a first stroke diagnosis, emigration, or death, whichever came first. Using Cox proportional-hazards regression, we computed hazard ratios (HRs) as estimates of the relative risk of stroke and 30-day mortality in adults with CHD compared with the general population, adjusted for sex and birth year.
Results: We identified 10,113 adults with CHD and 97,672 comparison cohort members. The risk of stroke among adults with CHD was more than two-fold increased compared with the general population (adjusted HR=2.2, 95% CI: 2.0-2.5). The 30-day stroke mortality was 11% for the 507 CHD subjects and 9.9% for the 3,115 comparison cohort members. This difference in risk corresponded to a 40% increased 30-day stroke mortality compared with the general population after adjustment for sex and birth year (HR=1.39, 95% CI: 1.04-1.86). CHD severity did not modify stroke mortality (mild to moderate CHD: HR=1.50, 95% CI: 1.05-2.14. Severe CHD and univentricular heart: HR=1.47, 95% CI: 0.81-2.67).
Conclusions: Adults with CHD had an increased risk of both experiencing and dying from a stroke.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Adult Patients With Congenital Heart Disease: How Do They Compare?
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1142-010
- 2017 American College of Cardiology Foundation