Abstract 20122: Where to Seek Care: Is it Beneficial for ACHD Patients to be Seen in a Specialized ACHD Clinic?
Background:There is a growing population of adults with repaired or palliated congenital heart disease. These patients receive cardiac care by a variety of clinical providers including, ongoing management by a pediatric cardiologist (PC), adult congenital heart disease (ACHD) specialist or adult cardiologist (AC). Recommendations for ongoing care include regular evaluation and attempted modification of obesity and other risk factors for acquired cardiovascular (CVS) disease. We wanted to find out what percentage of ACHD patients receives such counseling and whether this differs by the nature of provider delivering care.
Methods:Clinical records from routine yearly evaluations were reviewed on all ACHD patients with an age > 18 years seen at a single tertiary academic center with separate pediatric, ACHD and adult cardiac clinics over the period 4/2008-4/2010. Patients diagnosed in adulthood or mentally incapable of acknowledging counsel were excluded. Presence or absence of documentation of BP, weight, BMI, waist circumference (WC), lipid profile, activity, smoking status, and family history of early onset ischemic heart disease (CAD) were recorded. Counseling efforts aimed at mitigating CVS risk factors were recorded. For the purposes of recording counseling efforts, both diet and exercise history had to be obtained and counseling efforts documented. Data obtained from the 3 clinics was analyzed using z-tests, regression analysis and t-tests where appropriate.
Results:Of 526 patients seen, 126 were seen in PC clinic, 345 in ACHD clinic and 55 in AC clinic. Demographics of the 3 cohorts are shown in Table 1.
Summary:ACHD patients have a high prevalence of overweight or obesity. Despite this, our study suggests that patients seen in follow-up outside of an ACHD specialty clinic do not receive appropriate risk stratification and counseling.
- © 2010 by American Heart Association, Inc.