Abstract 17502: Exposure to Low-Dose Ionizing Radiation from Cardiac Procedures in Patients with Congenital Heart Disease: 15-Year Data from a Population-Based Longitudinal Cohort
Background: Medical procedures are increasingly recognized as an important source of low-dose ionizing radiation (LDIR) exposure. We analyzed data from the Quebec Congenital Heart Disease (CHD) Database to determine exposure rates to LDIR-related cardiac procedures from 1990-2005 in children and adults.
Methods: Exposure to cardiac procedures was classified as: catheter-based diagnostic procedures; structural heart interventions; coronary interventions; CT scans of the thorax; nuclear procedures; and pacemaker/ICD insertion and repair. Patient characteristics were explored for 3 categories of LDIR exposure: exposed to <1, 1-2, or >2 procedures per 10 patient years.
Results: From 1990-2005 there were 20,015 LDIR-exposed patients followed for 389,055 patient-years. Patients in the highest compared to the lowest exposure group were more likely to have a diagnosis of severe CHD (16.2% CI [15.2%, 17.2%] vs 9.3% CI [8.7%, 9.8%]), and were older (median age IQR 42.1 yrs [0, 54.9] vs. 36.4 yrs [13.3, 53.3]). The increasing total number of LDIR-related procedures performed per 1000 CHD patients per year are shown from 1990-2005 (Figure). A statistically significant linear increase over time in procedural rates was detected by Poisson regression (P < 0.0001). The total number of procedures performed in 1990 was 43.7 /1000 patients, and increased to 70.4 /1000 patients in 2005. This was accounted for by increases in rates per 1000 CHD patients in: structural heart interventions (1.0 /1000 to 5.2 /1000); coronary interventions (1.1 /1000 to 2.4 /1000); pacemaker/ICD insertions (1.6 /1000 to 4.2 /1000); and CT-scans of the chest (2.5 /1000 to 12.3 /1000).
Conclusions: Exposure of CHD patients to LDIR-emitting cardiac procedures increased significantly from 1990-2005. Our findings have implications for surveillance of LDIR exposure in this growing population of patients.
- © 2012 by American Heart Association, Inc.