3 years ago

Myocardial Infarction in Adults with Congenital Heart Disease

Reports indicate an increased prevalence of risk factors for acquired cardiovascular disease in adults with congenital heart disease (CHD). We compared the incidence and 30-day mortality of myocardial infarction (MI) in adults with CHD relative to the general population. This cohort study utilized nationwide population-based medical databases to identify individuals born before 1982 and diagnosed with CHD in Denmark between 1963 and 2012. Patients were followed for first time MI using data from the Danish National Registry of Patients. For each CHD subject we identified 10 controls from the general population, matched by sex and birth year. A unique personal identifier enabled follow-up for migration, death or MI. We computed cumulative incidences and hazard ratios (HR) adjusted for birth year and sex for MI and 30-day post-MI mortality. We identified 10,501 CHD adults alive at 30 years. By 70 years of age, the cumulative incidence of MI was 10% vs 6.5% for controls. The overall HR of MI among CHD subjects compared with controls was 2.0 (95% CI: 1.7-2.3). The 30-day mortality was 18% for the 296 CHD subjects experiencing an MI during follow-up. The overall HR comparing 30-day post-MI mortality between CHD subjects and controls was 1.4 (95% CI: 1.0-1.8). The greatest mortality was observed in adults with severe CHD [HR 2.7 (95% CI: 1.5-5.0)]. In conclusion, the incidence of MI, and the 30-day post-MI mortality for severe CHD, were increased in adults with CHD compared with the general population. Underlying mechanisms need to be clarified.

Publisher URL: www.sciencedirect.com/science

DOI: S0002914917314741

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