Abstract 15323: Increased Incidence of Cerebrovascular Events and Decreased Incidence of Coronary Events in Down Syndrome Individuals
The incidence of major cardiovascular events (CVEs) in Down Syndrome (DS) is unknown. We have performed a population-level cohort comparison of the incidence of major CVEs between individuals with and without DS. The sample was derived from a data set capturing all hospitalisations classified using the International Classification of Diseases within the Australian state of Victoria from 1993-2011. We identified 4,081 DS individuals (aged 20.9±20.8 years, mean±SD) and randomly selected 415,800 inpatient non-DS controls (37.8±25.7 years). A total of 151 DS patients (3.7%) and 36,598 non-DS patients (8.8%) suffered a CVE during the study period. Age at first CVE was 45.1±21.3 years in DS and 69.0±14.0 years in non-DS patients. When adjusted for age and sex, DS was associated with a greater risk of all strokes (OR, 2.75; 95% CI, 2.18-3.47), ischemic stroke (OR, 3.13; 95% CI, 2.24-4.39), hemorrhagic stroke (OR, 2.86; 95% CI, 1.92-4.27) and transient ischemic attacks (OR, 2.07; 95% CI, 1.28-3.36; all P<0.005). By contrast, DS individuals had a lower risk of myocardial infarction (OR, 0.72; 95% CI, 0.54-0.95; P<0.02) or angina (OR, 0.61; 95% CI, 0.43-0.86; P<0.005). The association between DS and all strokes remained when adjusted for hypertension (OR, 3.30; 95% CI, 2.61-4.18); diabetes mellitus (OR, 2.80; 95% CI, 2.22-3.53), atrial fibrillation (OR, 2.84; 95% CI, 2.25-3.58) or sleep apnea (OR, 2.75; 95% CI, 2.18-3.47), but was attenuated when adjusted for congenital heart disease (OR, 2.00; 95% CI, 1.57-2.55). In conclusion, DS is associated with a greater risk of cerebrovascular events but a lower risk of coronary events, and the former may be linked to the presence of congenital heart disease. Greater vigilance is required to minimise risk factors for stroke in DS individuals.
- © 2013 by American Heart Association, Inc.