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Meta-Analysis
. 2019 May 21;8(10):e012030.
doi: 10.1161/JAHA.119.012030.

Congenital Heart Disease and Risk of Cardiovascular Disease: A Meta-Analysis of Cohort Studies

Tingting Wang  1 , Lizhang Chen  1 , Tubao Yang  1 , Peng Huang  2 , Lesan Wang  1 , Lijuan Zhao  1 , Senmao Zhang  1 , Ziwei Ye  1 , Letao Chen  1 , Zan Zheng  1 , Jiabi Qin  1
Affiliations
Meta-Analysis

Congenital Heart Disease and Risk of Cardiovascular Disease: A Meta-Analysis of Cohort Studies

Tingting Wang et al. J Am Heart Assoc. .

Abstract

Background Despite remarkable success in the surgical and medical management of congenital heart disease ( CHD ), some survivors still experience cardiovascular complications over the long term. The goal of this study was to evaluate the association between CHD and risk of cardiovascular disease ( CVD ) by conducting a meta-analysis of cohort studies. Methods and Results A systematic literature search of several databases was conducted through April 2018 to identify studies reporting the risk of CVD , stroke, heart failure, and coronary artery heart disease in CHD survivors. The quality of individual studies was assessed using the Newcastle-Ottawa scale. The overall risk estimates were pooled using fixed-effects meta-analysis. Subgroup analyses were performed to explore possible sources of heterogeneity. Nine cohort studies comprising 684 200 participants were included. The overall combined relative risks for people with CHD compared with the controls were 3.12 (95% CI, 3.01-3.24) for CVD , 2.46 (95% CI, 2.30-2.63) for stroke, 5.89 (95% CI, 5.58-6.21) for heart failure, and 1.50 (95% CI, 1.40-1.61) for coronary artery heart disease. Significant heterogeneity was detected across studies regarding these risk estimates. Heterogeneity in the risk estimate of CVD was explained by geographic region, type of study design, sample source, age composition, and controlled confounders. Conclusions This meta-analysis of cohort studies of CHD found an association of increased risk of CVD in later life, although we cannot determine whether this association is confounded by a risk factor profile of CVD among CHD survivors or whether CHD is an independent risk factor.

Keywords: cardiovascular disease; congenital heart disease; coronary heart disease; heart failure; meta‐analysis; stroke; systematic review.

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Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Risk of cardiovascular disease associated with congenital heart disease (CHD).
Figure 3
Figure 3
Funnel plot with 95% confidence limits of the risk of cardiovascular disease associated with congenital heart disease. The solid line represents the summary effect estimates, and the dotted lines are pseudo 95% confidence limits.
Figure 4
Figure 4
Risk of stroke, heart failure, and coronary artery heart disease associated with congenital heart disease (CHD).
See this image and copyright information in PMC

References

    1. Khoshnood B, Lelong N, Houyel L, Thieulin AC, Jouannic JM, Magnier S, Delezoide AL, Magny JF, Rambaud C, Bonnet D, Goffinet F; EPICARD Study Group . Prevalence, timing of diagnosis and mortality of newborns with congenital heart defects: a population‐based study. Heart. 2012;98:1667–1673. - PubMed
    1. Hoffman JI, Kaplan S, Liberthson R. Prevalence of congenital heart disease. Am Heart J. 2004;147:425–439. - PubMed
    1. Tennant PW, Pearce MS, Bythell M, Rankin J. 20‐year survival of children born with congenital anomalies: a population‐based study. Lancet. 2010;375:649–656. - PubMed
    1. Zhao QM, Ma XJ, Ge XL, Liu F, Yan WL, Wu L, Ye M, Liang XC, Zhang J, Gao Y, Jia B, Huang GY; Neonatal Congenital Heart Disease screening group . Pulse oximetry with clinical assessment to screen for congenital heart disease in neonates in China: a prospective study. Lancet. 2014;384:747–754. - PubMed
    1. Marelli AJ, Mackie AS, Ionescu‐Ittu R, Rahme E, Pilote L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007;115:163–172. - PubMed

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