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Comparative Study
. 2017 Jun;38(5):965-973.
doi: 10.1007/s00246-017-1604-y. Epub 2017 Mar 24.

Red Flags for Maltese Adults with Congenital Heart Disease: Poorer Dental Care and Less Sports Participation Compared to Other European Patients-An APPROACH-IS Substudy

Maryanne Caruana  1 , Silke Apers  2   3 , Adrienne H Kovacs  4 , Koen Luyckx  5 , Corina Thomet  6 , Werner Budts  7 , Maayke Sluman  8 , Katrine Eriksen  9 , Mikael Dellborg  10   11 , Malin Berghammer  12   13 , Bengt Johansson  14 , Alexandra Soufi  15 , Edward Callus  16 , Philip Moons  2   10 , Victor Grech  17 ; APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD)
Collaborators, Affiliations
Comparative Study

Red Flags for Maltese Adults with Congenital Heart Disease: Poorer Dental Care and Less Sports Participation Compared to Other European Patients-An APPROACH-IS Substudy

Maryanne Caruana et al. Pediatr Cardiol. 2017 Jun.

Abstract

Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013-2015 during "Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study" (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale.

Keywords: Congenital heart disease; Health behaviour; Lifestyle; Risk factors.

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