Lower-complexity ACHD associated with increased CVD risk regardless of conventional risk factors
TUESDAY, March 26, 2019 (HealthDay News) — Individuals with lower-complexity adult congenital heart disease (ACHD) have a higher burden of adverse cardiovascular events than the general population, independent of conventional cardiovascular risk factors, according to a study published Feb. 28 in Circulation.
Priyanka Saha, from Stanford University School of Medicine in California, and colleagues attempted to quantify the risk for adverse cardiovascular events among 2,006 adults with lower-complexity ACHD compared with 497,983 adults without ACHD (median age, 58 years at enrollment) in the U.K. Biobank. Follow-up data were available for up to 22 years.
The researchers found that among the ACHD-diagnosed individuals, 69 percent were also diagnosed with or treated for hypertension, 41 percent were diagnosed with or treated for hyperlipidemia, and 7 percent were diagnosed with or treated for diabetes. ACHD remained strongly associated with fatal or nonfatal acute coronary syndrome (ACS), ischemic stroke, heart failure (HF), and atrial fibrillation, even after adjustment for 12 cardiovascular risk factors (hazard ratios ranged from 2 for ACS to 13 for HF). ACHD-exposed individuals with no more than two cardiovascular risk factors had a 29 percent age-adjusted incidence rate of major adverse cardiovascular events versus 13 percent in non-ACHD individuals with at least five risk factors.
“These findings highlight the need for closer surveillance of patients with mild-to-moderate ACHD and further investigation into management and mechanisms of cardiovascular risk unique to this growing population of high-risk adults,” the authors write.