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 aRiassunto |
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.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : ACC/AHA, CHD, ASCVD, AP, IQR, CI
Mappa
Vol 264
P. 1-9 - ottobre 2023 Ritorno al numero
Articolo precedente
- Patient characteristics and long-term outcomes in patients undergoing transcatheter aortic valve implantation in a failed surgical prosthesis vs in a native valve: A Danish nationwide study
- Xenia Begun, Jawad H. Butt, Søren L. Kristensen, Peter E. Weeke, Ole De Backer, Jarl E. Strange, Morten Schou, Lars Køber, Emil L. Fosbøl
- Impact of standard modifiable cardiovascular risk factors on 2-year all-cause mortality: Insights from an international cohort of 23,489 patients with acute coronary syndrome
- Maribel González-Del-Hoyo, Xavier Rossello, Vicente Peral, Stuart Pocock, Frans Van de Werf, Chee Tang Chin, Nicolas Danchin, Stephen W-L Lee, Jesús Medina, Yong Huo, Héctor Bueno
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?