1. Secundum atrial septal defect is associated with reduced survival in adult men
- Author
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Lodewijk J. Wagenaar, Berto J. Bouma, Aeilko H. Zwinderman, Teun van der Bom, Toon Oomen, Joey M. Kuijpers, Folkert J. Meijboom, Jolien W. Roos-Hesselink, Hubert W. Vliegen, Wilfred F. Heesen, A. Carla Zomer, Annelieke C.M.J. van Riel, Petronella G. Pieper, Barbara J.M. Mulder, W. Marc Waskowsky, Arie P.J. van Dijk, Graduate School, Cardiology, Amsterdam Public Health, Epidemiology and Data Science, Amsterdam Cardiovascular Sciences, Psychiatry, and Cardiovascular Centre (CVC)
- Subjects
PULMONARY ARTERIAL-HYPERTENSION ,medicine.medical_specialty ,Pediatrics ,SEX-DIFFERENCES ,Heart disease ,Survival ,Epidemiology ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Population ,Septum secundum ,UNITED-STATES ,CHILDREN ,Logistic regression ,SDG 3 - Good Health and Well-being ,Internal medicine ,MANAGEMENT ,medicine ,education ,Gender disparity ,POPULATION ,education.field_of_study ,business.industry ,MORTALITY ,Gender ,medicine.disease ,CONGENITAL HEART-DISEASE ,Adult life ,REGISTRY ,Heart failure ,CLOSURE ,Cardiology ,Patent foramen ovale ,Atrial septal defect ,National registry ,Morbidity ,Cardiology and Cardiovascular Medicine ,business - Abstract
Item does not contain fulltext AIMS: The identification of sex differences in the prognosis of adults with a secundum atrial septal defect (ASD2) could help tailor their clinical management, as it has in other cardiovascular diseases. We investigated whether disparity between the sexes exists in long-term outcome of adult ASD2 patients. METHODS AND RESULTS: Patients with ASD2 classified as the primary defect were selected from the Dutch national registry of adult congenital heart disease. Survival stratified by sex was compared with a sex-matched general population. In a total of 2207 adult patients (mean age at inclusion 44.8 years, 33.0% male), 102 deaths occurred during a cumulative follow-up of 13 584 patient-years. Median survival was 79.7 years for men and 85.6 years for women with ASD2. Compared with the age- and sex-matched general population, survival was lower for male, but equal for female patients (P = 0.015 and 0.766, respectively). Logistic regression analyses showed that men had a higher risk of conduction disturbances (OR = 1.63; 95% CI, 1.22-2.17) supraventricular dysrhythmias (OR = 1.41; 1.12-1.77), cerebrovascular thromboembolic events (OR = 1.53; 1.10-2.12), and heart failure (OR = 1.91; 1.06-3.43). CONCLUSION: In contrast to women, adult men with an ASD2 have worse survival than a sex-matched general population. Male patients also have a greater risk of morbidity during adult life. Sex disparity in survival and morbidity suggests the need for a sex-specific clinical approach towards these patients.
- Published
- 2015