Temporal Changes in Clinical Characteristics and Outcomes of Adults With Congenital Heart Disease - 13/09/23
, William R. Miranda, MD a, C. Charles Jain, MD a, Elizabeth H. Stephens, MD, PhD b, Kartik Andi, MBBS a, Omar Abozied, MBBS a, Heidi M. Connolly, MD aRésumé |
Background |
The purpose of this study was to assess differences in the clinical characteristics (defined by congenital heart disease [CHD] anatomic and physiologic classification scheme) of adults with CHD across different eras, and how these differences influence outcomes (heart failure hospitalization and all-cause mortality).
Method |
Patients were divided into depending on year of baseline encounter: cohort #1 (1991-2000, n = 1,984 [27%]), cohort #2 (2001-2010, n = 2,448 [34%]), and cohort #3 (2011-2020, n = 2,847 [39%]). Patients were classified into 3 anatomic groups (simple, moderate, and complex CHD) and 4 physiologic stages (stage A-D).
Results |
There was a temporal increase in the proportion of patients in physiologic stage C (17% vs 21% vs 24%, P < .001), and stage D (7% vs 8% vs 10%, P = .09), with a corresponding decrease in physiologic stage A (39% vs 35% vs 28%, P < .001). No temporal change in anatomic groups.
There was a temporal decrease in the incidence of all-cause mortality (12.7 vs 10.6 vs 9.5 per 1,000 patient-years, P < .001). However, there was a temporal increase in the incidence of heart failure hospitalization (6.8 vs 8.4 vs 11.2 per 1,000 patient-years, P < .001). CHD physiologic stage (but not anatomic groups) was associated with heart failure hospitalization and all-cause mortality.
Conclusions |
There is a need for better strategies to identify and treat heart failure, and to modify the risk factors associated with heart failure and all-cause mortality.
Le texte complet de cet article est disponible en PDF.Abbreviations : ACC/AHA, CHD, ASCVD, AP, IQR, CI
Plan
Vol 264
P. 1-9 - octobre 2023 Retour au numéro
Article précédent
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