| Cardiac outcomes after pregnancy in women with congenital heart disease. | |
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MedLine Citation:
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PMID: 20937754 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Women with congenital heart disease (CHD) are at risk for adverse cardiac events during pregnancy; however, the risk of events late after pregnancy (late cardiac events; LCE) has not been well studied. A study was undertaken to examine the frequency and determinants of LCE in a large cohort of women with CHD. DESIGN: Baseline characteristics and pregnancy were prospectively recorded. LCE (>6months after delivery) were determined by chart review. Survival analysis was used to determine the risk factors for LCE. SETTING: A tertiary care referral hospital. PATIENTS: The outcomes of 405 pregnancies were studied (318 women; median follow-up 2.6 years). MAIN OUTCOME MEASURES: LCE included cardiac death/arrest, pulmonary oedema, arrhythmia or stroke. RESULTS: LCE occurred after 12% (50/405) of pregnancies. The 5-year rate of LCE was higher in women with adverse cardiac events during pregnancy than in those without (27±9% vs 15±3%, HR 2.2, p=0.02). Women at highest risk for LCE were those with functional limitations/cyanosis (HR 3.9, 95% CI 1.2 to 13.0), subaortic ventricular dysfunction (HR 3.0, 95% CI 1.4 to 6.6), subpulmonary ventricular dysfunction and/or significant pulmonary regurgitation (HR 3.2, 95% CI 1.6 to 6.6), left heart obstruction (HR 2.6, 95% CI 1.2 to 5.2) and cardiac events before or during pregnancy (HR 2.6, 95% CI 1.3 to 4.9). In women with 0, 1 or >1 risk predictors the 5-year rate of LCE was 7±2%, 23±5% and 44±10%, respectively (p<0.001). CONCLUSIONS: In women with CHD, pre-pregnancy maternal characteristics can help to identify women at increased risk for LCE. Adverse cardiac events during pregnancy are important and are associated with an increased risk of LCE. |
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Authors:
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Olga H Balint; Samuel C Siu; Jennifer Mason; Jasmine Grewal; Rachel Wald; Erwin N Oechslin; Brigitte Kovacs; Mathew Sermer; Jack M Colman; Candice K Silversides |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 96 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-12 Completed Date: 2011-05-02 Revised Date: 2011-07-07 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 1656-61 Citation Subset: AIM; IM |
Affiliation:
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University of Toronto Pregnancy and Heart Disease Research Program, Mount Sinai and Toronto General Hospitals, Toronto, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arrhythmias, Cardiac / etiology Death, Sudden, Cardiac / etiology Epidemiologic Methods Female Heart Defects, Congenital / complications*, diagnosis Humans Maternal Age Parity Pregnancy Pregnancy Complications, Cardiovascular / diagnosis* Pregnancy Outcome Prognosis Pulmonary Edema / etiology Stroke / etiology Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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53030//Canadian Institutes of Health Research; 93722//Canadian Institutes of Health Research |
| Comments/Corrections | |
Comment In:
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Evid Based Med. 2011 Jun;16(3):93-4
[PMID:
21354981
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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