History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD
Background: Risk assessment in the expanding population of adult patients with congenital heart disease (ACHD) is of high importance. Aim: To report clinical characteristics, complications, mortality rate and causes of death in a single-centre ACHD cohort. Methods: Data were prospectively collected...
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doaj-4bee9715898e40b58fe93e68654107f32021-09-01T04:23:16ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852021-08-014100191History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHDDespoina Ntiloudi0Athanasios Koutsakis1Thomas Zegkos2Andreas Giannopoulos3George Efthimiadis4Haralambos Karvounis5George Giannakoulas6First Department of Cardiology, AHEPA University Hospital, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Thessaloniki, GreeceDepartment of Pediatric Cardiology, AHEPA University Hospital, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece; Corresponding author. St. Kyriakidi str 1, 54636, Thessaloniki, Greece.Background: Risk assessment in the expanding population of adult patients with congenital heart disease (ACHD) is of high importance. Aim: To report clinical characteristics, complications, mortality rate and causes of death in a single-centre ACHD cohort. Methods: Data were prospectively collected from an ACHD outpatient clinic from January 2012 until December 2019. Results: Of 356 patients (median age 34 years, 52.5% female), 116 (32.6%) were classified as simple, 182 (51.1%) as moderate and 58 (16.3%) as complex ACHD. At baseline assessment, more than half (n = 184) were symptomatic, while 69 patients (19.4%) had a history of arrhythmia and 21 (5.9%) a history of heart failure (HF) hospitalisation. Over a median follow-up of 4 years (1–7 years), 29 (8.1%) patients died, mainly due to HF. In multivariate Cox regression analysis, age [hazard ratio (HR) 1.03 (confidence interval (CI) 1.00–1.05), p = 0.034], Bethesda classification [HR 1.77 (CI 1.05–3.02), p = 0.034], NYHA class III/IV [HR 3.28 (CI 1.19–9.04), p = 0.022] and history of HF hospitalisation [HR 3.79 (CI 1.27–11.30), p = 0.017] predicted all-cause death. A total of 16.3% of patients developed complications, which were independently predicted by age [HR 1.03 (CI 1.01–1.05), p = 0.004], history of surgical procedure [HR 1.45 (CI 1.12–1.86), p = 0.004] and history of HF hospitalisation [HR 3.38 (CI 1.56–7.29), p = 0.002]. Conclusion: HF was the leading cause of death in this ACHD cohort and HF hospitalisation was a predictor of morbidity and mortality. These findings highlight the need for prevention of HF hospital admissions and strategies to improve postdischarge outcomes.http://www.sciencedirect.com/science/article/pii/S2666668521001154Adult congenital heart diseaseHeart failureHospitalisationMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Despoina Ntiloudi Athanasios Koutsakis Thomas Zegkos Andreas Giannopoulos George Efthimiadis Haralambos Karvounis George Giannakoulas |
spellingShingle |
Despoina Ntiloudi Athanasios Koutsakis Thomas Zegkos Andreas Giannopoulos George Efthimiadis Haralambos Karvounis George Giannakoulas History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD International Journal of Cardiology Congenital Heart Disease Adult congenital heart disease Heart failure Hospitalisation Mortality |
author_facet |
Despoina Ntiloudi Athanasios Koutsakis Thomas Zegkos Andreas Giannopoulos George Efthimiadis Haralambos Karvounis George Giannakoulas |
author_sort |
Despoina Ntiloudi |
title |
History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD |
title_short |
History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD |
title_full |
History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD |
title_fullStr |
History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD |
title_full_unstemmed |
History of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in ACHD |
title_sort |
history of heart failure hospitalisation predicts mortality in adult congenital heart disease morbidity and mortality in achd |
publisher |
Elsevier |
series |
International Journal of Cardiology Congenital Heart Disease |
issn |
2666-6685 |
publishDate |
2021-08-01 |
description |
Background: Risk assessment in the expanding population of adult patients with congenital heart disease (ACHD) is of high importance. Aim: To report clinical characteristics, complications, mortality rate and causes of death in a single-centre ACHD cohort. Methods: Data were prospectively collected from an ACHD outpatient clinic from January 2012 until December 2019. Results: Of 356 patients (median age 34 years, 52.5% female), 116 (32.6%) were classified as simple, 182 (51.1%) as moderate and 58 (16.3%) as complex ACHD. At baseline assessment, more than half (n = 184) were symptomatic, while 69 patients (19.4%) had a history of arrhythmia and 21 (5.9%) a history of heart failure (HF) hospitalisation. Over a median follow-up of 4 years (1–7 years), 29 (8.1%) patients died, mainly due to HF. In multivariate Cox regression analysis, age [hazard ratio (HR) 1.03 (confidence interval (CI) 1.00–1.05), p = 0.034], Bethesda classification [HR 1.77 (CI 1.05–3.02), p = 0.034], NYHA class III/IV [HR 3.28 (CI 1.19–9.04), p = 0.022] and history of HF hospitalisation [HR 3.79 (CI 1.27–11.30), p = 0.017] predicted all-cause death. A total of 16.3% of patients developed complications, which were independently predicted by age [HR 1.03 (CI 1.01–1.05), p = 0.004], history of surgical procedure [HR 1.45 (CI 1.12–1.86), p = 0.004] and history of HF hospitalisation [HR 3.38 (CI 1.56–7.29), p = 0.002]. Conclusion: HF was the leading cause of death in this ACHD cohort and HF hospitalisation was a predictor of morbidity and mortality. These findings highlight the need for prevention of HF hospital admissions and strategies to improve postdischarge outcomes. |
topic |
Adult congenital heart disease Heart failure Hospitalisation Mortality |
url |
http://www.sciencedirect.com/science/article/pii/S2666668521001154 |
work_keys_str_mv |
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