Prevalence and Outcome of Adults with Congenital Heart Disease and Coronary Artery Disease

BACKGROUND Little is known about the prevalence of outcome in patients with coronary artery disease (CAD) among adults with congenital heart disease (ACHD). The objectives of this study were to determine rates of ACHD and factors associated with outcomes among adults with CAD in a contemporary cohort within the China. METHODS Using pragmatic data from the Prospective Registry of the Current Status of Care for Patients with Coronary Artery Disease database, between January and May 2022, we stratified all CAD patients with comorbid ACHD or not. Using logistic regression method, we explored the risk factors associated with lower risk of mortality and stroke. We constructed a matching sub-cohort as sensitive analysis. RESULTS Of 10,517 evaluable patients 189 (1.8%) were with a diagnosis of ACHD, and were more female, more frequent with a history of atrial fibrillation, had a lower hemoglobin level at admission but less likely to have hypertension or smoking history than those without ACHD. In-hospital mortality before discharge was higher in patients with ACHD compared with no ACHD in the whole population (1.06% vs. 0.28%, p=0.05) and matched population (1.06% vs. 0.13%, p=0.04). Acute myocardial infarction (54.8%) represented the most common cause of death among all cohort, whereas 100% deaths among ACHD were due to ischemic stroke (2 cases). CONCLUSIONS ACHD was associated with a higher rate of mortality, which stroke complications contribute most. Future studies are needed to improve the acknowledge of underlying stroke mechanisms and prognosis in this special population. ### Competing Interest Statement Dr. Yan was funded by grants from the National Natural Science Foundation of China (82100260) and Beijing Hospitals Authority Youth Program (QML20210605). Dr. Li was funded by National Natural Science Foundation of China (82070483), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (XMLX202107), Beijing Municipal Commission of Education (KM202110025014), Beijing Municipal Science and Technology Commission (Z211100002921010). The other authors have no conflicts of interest to declare. ### Clinical Trial clinicaltrial.gov NCT 05337319 ### Funding Statement The prospective registry of the current status of care for patients with coronary artery disease has been funded by Beijing Anzhen hospital and National Clinical Research Center for Cardiovascular Diseases for quality improvement initiatives through an independent grant. This study was funded by grants from the National Natural Science Foundation of China (82100260), Beijing Hospitals Authority Youth Program (QML20210605), National Natural Science Foundation of China (82070483), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (XMLX202107), Beijing Municipal Commission of Education (KM202110025014), Beijing Municipal Science and Technology Commission (Z211100002921010). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The protocol was approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable Requests for the data underlying this article can be made to the corresponding author.