Sarah Cohen1, Aihua Liu1, Fei Wang2, Liming Guo1, James M Brophy3, Michal Abrahamowicz4, Judith Therrien1, Luc M Beauchesne5, Elisabeth Bédard6, Jasmine Grewal7, Paul Khairy8, Erwin Oechslin9, S Lucy Roche9, Candice K Silversides9, Isabelle F Vonder Muhll10, Ariane J Marelli11. 1. McGill Adult Unit for Congenital Heart Disease Excellence, Montréal, Québec, Canada. 2. McGill Adult Unit for Congenital Heart Disease Excellence, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada. 3. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada; Division of Cardiology, McGill University Health Centre, Canada. 4. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada. 5. Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. 6. Quebec Heart & Lung Institute, Laval University, Quebec City, Québec, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. 7. Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. 8. Montréal Heart Institute, Université de Montréal, Montréal, Québec, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. 9. Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. 10. Division of Cardiology, Department of Internal Medicine, Mazankowski Alberta Heart Institute, University of Alberta Hospital, Edmonton, Alberta, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. 11. McGill Adult Unit for Congenital Heart Disease Excellence, Montréal, Québec, Canada; iCACH Net Group (Canadian Adult Congenital Heart Disease Network Investigators' Group), Canada. Electronic address: ariane.marelli@mcgill.ca.
Abstract
BACKGROUND: Heart failure (HF) is the leading cause of death in adult patients with congenital heart disease (ACHD). No risk prediction model exists for HF hospitalization (HFH) for ACHD patients. We aimed to develop a clinically relevant one-year risk prediction system to identify ACHD patients at high risk for HFH. METHODS: Data source was the Quebec CHD Database. A retrospective cohort including all ACHD patients aged 18-64 (1995-2010) was constructed for assessing the cumulative risk of HFH adjusting for competing risk of death. To identify one-year predictors of incident HFH, multivariable logistic regressions were employed to a nested case-control sample of all ACHD patients aged 18-64 in 2009. The final model was used to create a risk score system based on adjusted odds ratios. RESULTS: The cohort included 29,991 ACHD patients followed for 648,457 person-years. The cumulative HFH risk by age 65 was 12.58%. The case-control sample comprised 26,420 subjects, of whom 189 had HFHs. Significant one-year predictors were age ≥ 50, male sex, CHD lesion severity, recent 12-month HFH history, pulmonary arterial hypertension, chronic kidney disease, coronary artery disease, systemic arterial hypertension, and diabetes mellitus. The created risk score ranged from 0 to 19. The corresponding HFH risk rose rapidly beyond a score of 8. The risk scoring system demonstrated excellent prediction performance. CONCLUSIONS: One eighth of ACHD population experienced HFH before age 65. Age, sex, CHD lesion severity, recent 12-month HFH history, and comorbidities constructed a risk prediction model that successfully identified patients at high risk for HFH.
BACKGROUND:Heart failure (HF) is the leading cause of death in adult patients with congenital heart disease (ACHD). No risk prediction model exists for HF hospitalization (HFH) for ACHD patients. We aimed to develop a clinically relevant one-year risk prediction system to identify ACHD patients at high risk for HFH. METHODS: Data source was the Quebec CHD Database. A retrospective cohort including all ACHD patients aged 18-64 (1995-2010) was constructed for assessing the cumulative risk of HFH adjusting for competing risk of death. To identify one-year predictors of incident HFH, multivariable logistic regressions were employed to a nested case-control sample of all ACHD patients aged 18-64 in 2009. The final model was used to create a risk score system based on adjusted odds ratios. RESULTS: The cohort included 29,991 ACHD patients followed for 648,457 person-years. The cumulative HFH risk by age 65 was 12.58%. The case-control sample comprised 26,420 subjects, of whom 189 had HFHs. Significant one-year predictors were age ≥ 50, male sex, CHD lesion severity, recent 12-month HFH history, pulmonary arterial hypertension, chronic kidney disease, coronary artery disease, systemic arterial hypertension, and diabetes mellitus. The created risk score ranged from 0 to 19. The corresponding HFH risk rose rapidly beyond a score of 8. The risk scoring system demonstrated excellent prediction performance. CONCLUSIONS: One eighth of ACHD population experienced HFH before age 65. Age, sex, CHD lesion severity, recent 12-month HFH history, and comorbidities constructed a risk prediction model that successfully identified patients at high risk for HFH.
Authors: Chun-Wei Lu; Jou-Kou Wang; Hsiao-Ling Yang; Adrienne H Kovacs; Koen Luyckx; Francisco Javier Ruperti-Repilado; Alexander Van De Bruaene; Junko Enomoto; Maayke A Sluman; Jamie L Jackson; Paul Khairy; Stephen C Cook; Shanthi Chidambarathanu; Luis Alday; Erwin Oechslin; Katrine Eriksen; Mikael Dellborg; Malin Berghammer; Bengt Johansson; Andrew S Mackie; Samuel Menahem; Maryanne Caruana; Gruschen Veldtman; Alexandra Soufi; Susan M Fernandes; Kamila White; Edward Callus; Shelby Kutty; Silke Apers; Philip Moons Journal: J Am Heart Assoc Date: 2022-04-26 Impact factor: 6.106
Authors: Laurie W Geenen; Alexander R Opotowsky; Cara Lachtrupp; Vivan J M Baggen; Sarah Brainard; Michael J Landzberg; David van Klaveren; Hester F Lingsma; Eric Boersma; Jolien W Roos-Hesselink Journal: Eur Heart J Qual Care Clin Outcomes Date: 2022-01-05