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Comparison in the adult congenital heart disease severity classification of ACC/AHA and ESC guidelines in a 3,459 Mexican population. | LitMetric

AI Article Synopsis

  • A registry study analyzed the clinical and demographic profiles of adults with congenital heart disease (ACHD) in Latin America, finding that 83.41% of the 3,459 patients included were alive, with various health characteristics observed.* -
  • There was a low level of agreement (43.29%) between the 2020 ESC and 2018 AHA/ACC guidelines for classifying moderate complexity ACHD, while the agreement for severe cases was high (83.10%).* -
  • The study concluded that patients with more severe symptoms (NYHA III-IV), arrhythmias, or receiving palliative care had higher mortality rates, and those who underwent surgical repairs had better survival odds compared to those under

Article Abstract

Background: Latin American registries of clinical and demographic profiles of ACHD are scarce. International guidelines classify disease complexity with different approaches. With these two regards, a registry was carried out to examine factors associated with mortality and to compare severity classifications in our population.

Methods And Results: Cross-sectional study conducted on ACHD between 2018 and 2022 to evaluate clinical and demographic characteristics and to assess the agreement between the 2020 ESC Guidelines and 2018 AHA/ACC Guidelines for the Management of Adults with Congenital Heart Disease using the method. Binomial logistic regression models were used to examine correlates of mortality. 3459 patients were included [56 % women, median age 34 years (IQR 24-50)]; 83.41 % were alive and 4.11 % died. The subjects had the following characteristics: 74.18 % were in NYHA I FC, 87.30 % had SVEF ≥50 %, 18.42 % developed arrhythmias, 58.92 % were surgically repaired, 7.05 % received palliative management, and 0.03 % were in heart transplant protocol. The agreement between ESC and AHA/ACC complexity classifications was low (43.29 %) in moderate ACHD, and high (83.10 %) in severe disease. Mortality was higher in patients with NYHA III-IV FC, arrhythmias and under palliative care.

Conclusion: This study found that ESC and AHA/ACC complexity classifications have limited concordance in categorizing moderate complexity CHD. Reparative procedures had lower mortality odds than palliative care.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657258PMC
http://dx.doi.org/10.1016/j.ijcchd.2024.100492DOI Listing

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