963Atherosclerotic risk factors are associated with coronary artery disease but not with ischemic stroke in adults with congenital heart disease

Background: Aging adults with congenital heart disease (ACHD) are at risk for acquired cardiovascular disease. However, knowledge on risk factors remains limited. Purpose: To determine factors associated with coronary artery disease (CAD) and ischemic stroke in aging ACHD patients in order to inform preventive measures. Methods: We performed a multicenter case-control study, using data from a large registry to identify ACHD patients within one of five participating centers. Patients with CAD were matched (1:2 ratio) with ACHD patients on age, CHD defect group and gender. Patients with ischemic stroke (or transient ischemic attack (TIA)) were matched similarly. Medical charts were reviewed and a standardized questionnaire was used. Results: Of 6904 ACHD patients within 5 participating centers, a total of 55 cases with CAD (80% male, mean age 55.1±12.4 years) and 56 cases with stroke (46% male, mean age 46.9±15.2) were included. All ACHD case patients were matched with 2 ACHD control patients without CAD or ischemic stroke. Factors associated with CAD and ischemic stroke in univariate logistic regression analysis are shown in figure 1. In multivariable analysis, traditional atherosclerotic risk factors such as hypertension (OR 2.19, p=0.03), hypercholesterolemia (OR 3.74, p=0.003), and smoking (OR 2.07, p=0.04) remained associated with CAD. In contrast, these factors were not associated ischemic stroke. In multivariable analysis, ischemic stroke was associated with previous shunt operations (OR 3.60, p=0.01), residual/unclosed septal defects (OR 2.36, p=0.04), and left-sided mechanical valves (OR 2.76, p=0.02).