Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 6;8(15):e011870.
doi: 10.1161/JAHA.118.011870. Epub 2019 Jul 18.

Ischemic Stroke in Adults With Congenital Heart Disease: A Population-Based Cohort Study

Mette Glavind Bülow Pedersen  1 , Morten S Olsen  1   2 , Morten Schmidt  1   3 , Søren P Johnsen  1   4 , Christopher Learn  5 , Henning B Laursen  1 , Nicolas L Madsen  1   6   7
Affiliations

Ischemic Stroke in Adults With Congenital Heart Disease: A Population-Based Cohort Study

Mette Glavind Bülow Pedersen et al. J Am Heart Assoc. .

Abstract

Background Congenital heart disease (CHD) is associated with risk factors for ischemic stroke including cardiac arrhythmias and heart failure. However, few long-term follow-up data exist on ischemic stroke risk and associated mortality in adults with CHD. Methods and Results Using Danish nationwide registries, we identified individuals aged ≥18 years diagnosed with CHD, at any age, from 1963 to 2017 and a sex and birth year-matched (1:10) general population comparison cohort. We computed risks, as well as sex and birth year-adjusted hazard ratios (aHRs) for ischemic stroke and 30-day post-stroke mortality in CHD adults compared with the general population. Analyses were stratified according to age <60 years (young) and ≥60 years (older). We identified 16 836 adults with CHD. The risk of ischemic stroke at age 60 years was 7.4% in the CHD cohort and 2.9% in the general population cohort. The adjusted hazard ratios for ischemic stroke compared with the general population was 3.8 (95% CI: 3.3-4.3) in young CHD adults and 1.6 (95% CI: 1.4-1.9) in older CHD adults. The adjusted hazard ratios for post-stroke mortality compared with the general population was 2.3 (95% CI: 1.2-4.4) in young CHD adults and 1.3 (95% CI: 0.9-1.9) in older CHD adults. Conclusions Both younger and older CHD adults have an increased risk of ischemic stroke and by 60 years of age 7.4% of CHD adults will have had an ischemic stroke. Post-stroke mortality was also increased in CHD adults compared with the general population.

Keywords: congenital heart disease; population‐based; prognosis; stroke.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cumulative incidence of ischemic stroke with death as competing risk in congenital heart disease adults (n=16 836) diagnosed in Denmark from 1963 to 2017 and general population adults (n=168 360).
Figure 2
Figure 2
Thirty‐day post‐ischemic stroke mortality in congenital heart disease adults and the general population according to young (<60 years) and older age (≥60 years).
See this image and copyright information in PMC

References

    1. Marelli AJ, Ionescu‐Ittu R, Mackie AS, Guo L, Dendukuri N, Kaouache M. Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Circulation. 2014;130:749–756. - PubMed
    1. Bouchardy J, Therrien J, Pilote L, Ionescu‐Ittu R, Martucci G, Bottega N, Marelli AJ. Atrial arrhythmias in adults with congenital heart disease. Circulation. 2009;120:1679–1686. - PubMed
    1. Fahed AC, Roberts AE, Mital S, Lakdawala NK. Heart failure in congenital heart disease: a confluence of acquired and congenital. Heart Fail Clin. 2014;10:219–227. - PMC - PubMed
    1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–988. - PubMed
    1. Hays AG, Sacco RL, Rundek T, Sciacca RR, Jin Z, Liu R, Homma S, Di Tullio MR. Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population. Stroke. 2006;37:1715–1719. - PMC - PubMed

Publication types