Sudden death in adults with repaired coarctation of the aorta: A case for sex-based risk factors
Lauren Lastinger1, Marc Lee2, Lauren Hassen1
1The Ohio State University, Department of Internal Medicine, Division of Cardiovascular Medicine, Columbus, OH, USA.
Summary
Sudden cardiac death (SCD) risk is high in adults with repaired coarctation of the aorta (rCoA). Prolonged QTc interval significantly increases SCD risk, particularly in men, while age is a key factor for women.
Area of Science:
- Cardiology
- Adult Congenital Heart Disease
- Electrophysiology
Background:
- Sudden cardiac death (SCD) poses a significant risk for adults with repaired coarctation of the aorta (rCoA).
- Understanding clinical risk factors for SCD in this population is crucial for improved patient outcomes.
Purpose of the Study:
- To determine clinical risk factors for sudden cardiac death (SCD) in adults with repaired coarctation of the aorta (rCoA).
Main Methods:
- Retrospective evaluation of SCD events and clinical data from adults with rCoA at a tertiary care center (2007-2017).
- Analysis included 167 adults with rCoA, assessing QTc interval, age, sex, and other clinical factors.
Main Results:
- Adults with rCoA had a 5% SCD rate, significantly higher than age-matched controls (0.9%).
- Prolonged QTc interval was associated with a 12-fold increased SCD risk.
- QTc prolongation selectively increased SCD risk in men, while advanced age was a risk factor for women.
Conclusions:
- There is a high, unanticipated burden of SCD in adults with rCoA, occurring at younger ages in men.
- Sex-specific risk stratification for SCD in rCoA is essential for understanding and managing this late complication.
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