Abstract 11657: Heart Failure in Adults with Congenital Heart Disease
Objective Heart failure (HF) is a serious complication and often the cause of death in adult patients with congenital heart disease (CHD). Our aim was to assess the frequency of HF-admissions and to determine risk factors of HF-admission in adult patients.
Methods The Dutch CONCOR registry was linked to the Hospital Discharge Registration to obtain data on hospital admissions for HF. Cox regression models were used to assess independent risk factors of hospitalisation for HF in adulthood.
Results Of 10,808 adult patients (49% male), 274 (2.5%) were admitted for HF during a mean follow-up period of 21 years. Median age at first HF-admission was 46.0 years (range=19.2 to 90.9) and 51% were male. The cumulative observed risk for admission for HF in adulthood was 1.2% at the age of 40 years and 5.8% at the age of 60 years. Patients admitted for HF had a four times higher risk of mortality than patients not admitted (adjusted hazard ratio (HR)=3.8; 95% confidence interval (CI) 3.3-4.3). Main congenital heart defect was identified as independent risk factor, with highest risks for patients with univentricular hearts (HR=11.4; 95% CI 5.9-22.0), and congenitally and surgically corrected transposition of the great arteries (HR=5.2; 95% CI 1.8-15.4 and HR=5.0; 95% CI 2.5-9.9 respectively). Other independent risk factors of HF-admission were the presence of multiple defects and surgical intervention in childhood.
Conclusions Our results show a relatively low incidence of admissions for heart failure in adults with congenital heart disease. However, mortality risk is increased in patients admitted for heart failure. Therefore, identification of patients at high risk for heart failure admission and subsequent mortality is important, as preventive measures might lead to improved quality of life and life expectancy.
- © 2011 by American Heart Association, Inc.