TY - JOUR
T1 - Secundum atrial septal defect is associated with reduced survival in adult men
AU - Kuijpers, Joey M.
AU - van der Bom, Teun
AU - van Riel, Annelieke C. M. J.
AU - Meijboom, Folkert J.
AU - van Dijk, Arie P. J.
AU - Pieper, Petronella G.
AU - Vliegen, Hubert W.
AU - Waskowsky, W. Marc
AU - Oomen, Toon
AU - Zomer, A. Carla
AU - Wagenaar, Lodewijk J.
AU - Heesen, Wilfred F.
AU - Roos-Hesselink, Jolien W.
AU - Zwinderman, Aeilko H.
AU - Mulder, Barbara J. M.
AU - Bouma, Berto J.
PY - 2015/8/14
Y1 - 2015/8/14
N2 - 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 ageand 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.
AB - 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 ageand 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.
KW - Atrial septal defect
KW - Gender
KW - Survival
KW - Morbidity
KW - Epidemiology
KW - CONGENITAL HEART-DISEASE
KW - PULMONARY ARTERIAL-HYPERTENSION
KW - SEX-DIFFERENCES
KW - UNITED-STATES
KW - MORTALITY
KW - POPULATION
KW - MANAGEMENT
KW - CHILDREN
KW - CLOSURE
KW - REGISTRY
U2 - 10.1093/eurheartj/ehv097
DO - 10.1093/eurheartj/ehv097
M3 - Article
SN - 0195-668X
VL - 36
SP - 2079
EP - 2086
JO - European Heart Journal
JF - European Heart Journal
IS - 31
ER -