Prevalence and Outcome of Adults with Congenital Heart Disease and Coronary Artery Disease

BACKGROUNDLittle is known about the prevalence of outcome in patients with coronary artery disease (CAD) among adults with congenital heart disease (ACHD). The objectives of this study were to determine rates of ACHD and factors associated with outcomes among adults with CAD in a contemporary cohort within the China. METHODSUsing pragmatic data from the Prospective Registry of the Current Status of Care for Patients with Coronary Artery Disease database, between January and May 2022, we stratified all CAD patients with comorbid ACHD or not. Using logistic regression method, we explored the risk factors associated with lower risk of mortality and stroke. We constructed a matching sub-cohort as sensitive analysis. RESULTSOf 10,517 evaluable patients 189 (1.8%) were with a diagnosis of ACHD, and were more female, more frequent with a history of atrial fibrillation, had a lower hemoglobin level at admission but less likely to have hypertension or smoking history than those without ACHD. In-hospital mortality before discharge was higher in patients with ACHD compared with no ACHD in the whole population (1.06% vs. 0.28%, p=0.05) and matched population (1.06% vs. 0.13%, p=0.04). Acute myocardial infarction (54.8%) represented the most common cause of death among all cohort, whereas 100% deaths among ACHD were due to ischemic stroke (2 cases). CONCLUSIONS ACHD was associated with a higher rate of mortality, which stroke complications contribute most. Future studies are needed to improve the acknowledge of underlying stroke mechanisms and prognosis in this special population.