Nationwide case-control study (2000-2022) of 214 adults with congenital heart disease (ACHD) and their first acute myocardial infarction, matched to 2,092 controls without ACHD on age, sex, hypertension, diabetes, hyperlipidaemia, and previous PCI/CABG. ACHD patients were younger at first infarction (58 vs 70 years). Over a mean follow-up of 6.5 (ACHD) and 7.3 years (controls), no difference emerged in mortality or recurrent MI at 1 year. At 10 years, mortality appeared higher in ACHD (HR 1.4; 95% CI 1.0-1.9) but lost significance after adjustment. The findings suggest ACHD patients have survival similar to the general population after MI. Since they share the same cardiovascular risk factors, healthy lifestyle and proactive risk management remain essential to prevent acquired heart disease in this growing population.
A nationwide case control study was conducted between 2000 and 2022. Patients with ACHD (n = 214) and controls (n = 275 377) who experienced their first AMI were identified. Of these, each patient (n = 213) with ACHD was matched with 10 controls (n = 2092) based on age, sex, hypertension, diabetes, hyperlipidaemia, and history of percutaneous coronary intervention or coronary artery bypass grafting. Mortality and recurrent AMI were assessed using unadjusted and adjusted Cox regression for matching and other clinical covariates.
Patients with ACHD were younger (58 ± 14 years) than controls (70 ± 12 years) before the matching (P < .001). The mean follow-up time was 6.5 and 7.3 years for patients with ACHD and controls, respectively. There was no significant difference in mortality or recurrent AMI rates at 1 year between patients with ACHD and matched controls. The mortality rate was higher in ACHD at 10 years of follow-up (hazard ratio 1.4, 95% confidence interval 1.0-1.9) but did not remain after adjustment.
This study suggests that survival rates and the incidence of recurrent AMI in ACHD patients are similar to those of controls. Since patients with ACHD share similar cardiovascular risk factors as the general population, promoting healthy lifestyles and proactive risk management is crucial to mitigate acquired heart disease.
