Trends in mortality of adult congenital heart disease patients in the last 4 decades. (14th October 2021)

• Record Type: Journal Article
• Authors: Mano, T; Viegas, J; Bras, P; Rito, T; Agapito, A; Pinto, F; Cruz Ferreira, R; De Sousa, L
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Epidemiology, Prognosis, Outcome; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.1844
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Introduction: Medical, surgical, and technological advances over the past decades increased the life expectancy of congenital heart disease (CHD) patients (pts), with >90% reaching adulthood. Nonetheless, mortality for adults with CHD (ACHD) is still higher than for the general population. Purpose: To analyse trends in mortality and causes of death of ACHD. Methods: Retrospective analysis of pts followed in an ACHD outpatient clinic, in one tertiary center, who died between 1980 and December 2020. Data relating to the cardiac diagnosis, symptoms, interventions, comorbidities, and causes of death were analysed. Results: During a median follow-up of 8.9 years (IQR 2.2–17), 251 pts of 3725 (6.7%) died during the study period: 127 males (51%), mean age at death 44.9±18.1 years, 54% with severe CHD. The majority of these death was CHD-related (171 pts – 68.1%) with no statistically significant differences over the years vs non-cardiovascular death (Table 1). However, a paradigm shift was noticed: in the first years the main cardiac cause was sudden-death that was replaced by heart failure in the last decade. Also, the mean age at death increased over the years (33±14.9 years until 2000 vs 52.3±17 years after the year 2010, p<0.001) as the number of implantable devices (4 vs 20, p=0.05). Conclusion: Causes of death of ACHD patients are in the majority still CHD-related. However, in the last decade, according to the increase in life expectancy, heart failure became the leading cause of death. FUNDunding Acknowledgement: Type of funding sources: None.