Clinical Characteristics in Adult Congenital Heart Disease Patients With Acute Stroke - A Retrospective Analysis
Naoki Makita1,2, Manabu Inoue1, Kenichi Kurosaki3
1Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center Osaka Japan.
Insights
Adults with congenital heart disease (ACHD) experiencing stroke are younger and more prone to large vessel occlusion (LVO). Atrial septal defect (ASD) is the most common type. These findings aid stroke treatment and prevention strategies.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- The prevalence of adult congenital heart disease (ACHD) is increasing due to improved pediatric care.
- Acute stroke treatment and prevention in ACHD patients remain understudied.
- This study investigates the clinical profile of ACHD patients who have suffered a stroke.
Purpose of the Study:
- To analyze the clinical characteristics of ACHD patients experiencing acute stroke.
- To compare stroke incidence, type, and outcomes in ACHD patients versus the general stroke population.
- To inform the development of targeted stroke management strategies for ACHD.
Main Methods:
- Retrospective single-center study of adult stroke patients admitted between January 2011 and March 2017.
- Analysis of 22 ACHD patients among 4,837 adult stroke cases.
- Comparison of clinical features, stroke type (ischemic vs. intracerebral hemorrhage), large vessel occlusion (LVO) rates, and functional outcomes (modified Rankin Scale) between ACHD and non-CHD groups.
Main Results:
- ACHD patients were significantly younger (median 56 vs. 75 years) than non-CHD stroke patients.
- A higher incidence of large vessel occlusion (LVO) was observed in the ACHD group (53% vs. 24%).
- ACHD patients showed more favorable functional outcomes at discharge (median mRS 2 vs. 3), with atrial septal defect (ASD) being the most common underlying condition (55%).
Conclusions:
- ACHD patients with stroke are younger and have a higher likelihood of LVO, with ASD being the most frequent diagnosis.
- Despite favorable short-term outcomes, these distinct characteristics necessitate tailored acute treatment and prevention strategies.
- Further research is needed to optimize stroke care pathways for the growing ACHD population.
Background:
The number of adult congenital heart disease (ACHD) patients is rising due to advancements in surgery and medical treatment for congenital heart disease (CHD) during childhood. However, acute treatment and stroke prevention measures in ACHD patients have been insufficiently assessed. To address this insufficiency, we conducted a retrospective single-center investigation of the clinical characteristics of ACHD patients who experienced stroke.
Methods And Results:
We studied adult patients with acute stroke hospitalized within 7 days of onset between January 2011 and March 2017. Among 4,837 adults with stroke, 22 (0.5%) had CHD, including 19 with ischemic stroke and 3 with intracerebral hemorrhage. Compared with the non-CHD group, the ACHD group was younger (median age 56 vs. 75 years; P<0.01), had a higher incidence of large vessel occlusion (LVO; 53 vs. 24%; P=0.01), and exhibited more favorable functional outcomes at discharge (median modified Rankin scale 2 vs. 3; P=0.03). Atrial septal defect (ASD) was the most common underlying CHD, accounting for 55% of cases.
Conclusions:
ACHD patients with acute stroke were significantly younger and more frequently developed LVO compared with the general stroke population, with ASD being the most common type of CHD. Despite their favorable short-term prognosis, these characteristics must be considered to implement effective acute treatment and prevention strategies.
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