Impact of age and sex on survival and causes of death in adults with congenital heart disease
Impact of age and sex on survival and causes of death in adults with congenital heart disease
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DOI：
10.1016/j.ijcard.2017.06.060
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发表时间：
2017-10-15
影响因子：
3.5
通讯作者：
Fernandez-Aviles, Francisco
中科院分区：
文献类型：
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作者：
Maria Oliver, Jose;Gallego, Pastora;Fernandez-Aviles, Francisco
背景：性别和年龄对先天性心脏病 (ACHD) 成人相对生存率和死亡原因的影响尚不清楚。方法：对 3311 名连续 ACHD（50.5% 男性）进行长达 25 年的单中心观察性纵向研究。根据最后一次随访时的年龄将患者分为三组：65 岁。他们的生命状况通过交叉检查西班牙国家死亡指数得到验证。建立了参考人群相对生存率的回归模型。死亡原因根据国际疾病分类（ICD-10）进行分类。对因心血管 (CV) 原因死亡的患者进行了逐案进一步调查。结果：在 37,608 人年的累计随访时间内，336 名患者死亡 (10%)。女性的年龄调整相对生存率显着低于男性（风险比 [HR] 1.25；95% 置信区间 [CI] 1.0-1.6；p = 0.046），并且三组年龄组的性别调整相对生存率有所改善（HR 0.98；95% CI 0.97-0.99；p < 0.001）。两性的心血管死亡随着年龄的增长而暂时下降（p < 0.001）。心血管死亡的主要原因是心力衰竭，但猝死在受试者中普遍存在
Background: The impact of gender and aging on relative survival and causes of death in adults with congenital heart disease (ACHD) are not well known.Methods: Single center observational longitudinal study of 3311 consecutive ACHD (50.5% males) followed up to 25 years. Patients were divided by the age at last follow-up into three groups: 65 years old. Their vital status was verified by crosschecking the Spanish National Death Index. Regression model for relative survival from reference population was performed. Cause of death was classified according to the International Classification of Diseases (ICD-10). Patients who died from cardiovascular (CV) causes were further investigated on a case-by-case basis.Results: During a cumulative follow-up time of 37,608 person-years 336 patients died (10%). Age-adjusted relative survival in females was significantly worse than in males (hazard ratio [HR] 1.25; 95% confidence interval [CI] 1.0-1.6; p = 0.046), and sex-adjusted relative survival improved across the three group of ages (HR 0.98; 95% CI 0.97-0.99; p < 0.001). There was a temporal decline of CV deaths with aging in both genders (p < 0.001). The leading cause of CV death was heart failure but sudden death prevailed in subjects