Key result
Severe congenital heart disease was associated with a median age at death of 46.0 years and a 60% rate of cardiovascular death, whereas nonsevere disease was more commonly associated with non-CHD deaths.
Why the study?
Little was known about the contemporary mortality experience, age at death, cardiovascular comorbidities, and most common causes of death among adults with congenital heart disease in the United States.
What are the age at death, cardiovascular comorbidities, and most common causes of death among adults with congenital heart disease?
Cohort (n=629)
Yes
What are the age at death, cardiovascular comorbidities, and most common causes of death among adults with congenital heart disease?
Adults with severe congenital heart disease die significantly younger and primarily from cardiovascular causes, whereas those with nonsevere disease die at an older age primarily from non-CHD causes such as malignancy and ischemic heart disease.
Supports closer CV monitoring in severe adult CHD; hypothesis-generating for targeted interventions to reduce premature CV mortality.
Background Little is known about the contemporary mortality experience among adults with congenital heart disease (CHD). The objectives of this study were to assess the age at death, presence of cardiovascular comorbidities, and most common causes of death among adults with CHD in a contemporary cohort within the United States. Methods and Results Patients with CHD who had a healthcare encounter between 2008 and 2013 at 1 of 5 comprehensive CHD centers in North Carolina were identified by International Classification of Diseases, Ninth Revision ( ICD‐9 ), code. Only patients who could be linked to a North Carolina death certificate between 2008 and 2016 and with age at death ≥20 years were included. Median age at death and underlying cause of death based on death certificate data were analyzed. The prevalence of acquired cardiovascular risk factors was determined from electronic medical record data. Among the 629 included patients, the median age at death was 64.2 years. Those with severe CHD (n=157, 25%), shunts (n=202, 32%), and valvular lesions (n=174, 28%) had a median age at death of 46.0, 65.0, and 73.3 years, respectively. Cardiovascular death was most common in adults with severe CHD (60%), with 40% of those deaths caused by CHD. Malignancy and ischemic heart disease were the most common causes of death in adults with nonsevere CHD. Hypertension and hyperlipidemia were common comorbidities among all CHD severity groups. Conclusions The most common underlying causes of death differed by lesion severity. Those with severe lesions most commonly died from underlying CHD, whereas those with nonsevere disease more commonly died from non‐CHD causes.
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Goldstein et al. (2020) conducted a cohort in Congenital heart disease (n=629). Severe congenital heart disease vs. Nonsevere congenital heart disease was evaluated on Age at death and underlying cause of death. Severe congenital heart disease was associated with a median age at death of 46.0 years and a 60% rate of cardiovascular death, whereas nonsevere disease was more commonly associated with non-CHD deaths.
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