Background: The population of adults with congenital heart diseases
(ACHDs) is expanding, and atrial fibrillation (AF) emerges as a crucial risk
factor for ischemic stroke. However, the evidence regarding the impact of AF on
the incidence of ischemic stroke in ACHDs remains limited. In this study, we
aimed to investigate the prevalence and effect of AF among ACHDs and assess the
suitability of the traditional CHA₂DS₂-VASc score in this specific population.
Methods: Data of ACHDs from 2000 to 2010 were retrospectively collected
from the Taiwan National Health Insurance Research Database. We divided ACHDs
into those with and without AF, and ischemic stroke incidence was studied among
ACHD subtypes and those who received anticoagulant therapy with warfarin or not
according to CHA₂DS₂-VASc score. Results: 36,530 ACHDs were retrieved
from the database. ACHDs had a 4.7–15.3 times higher AF risk than did the
general population, which varied based on the age group. ACHDs with AF had 1.45
times higher ischemic stroke risk than those without AF (p = 0.009).
Ischemic stroke incidence among ACHDs with AF aged
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Open Access
Original Research
Atrial Fibrillation in Adult Congenital Heart Increase Ischemic Stroke Risk Even at Low CHA2DS2-VASc Score
Yu-Sheng Lin1,2,3, Yi-Chun Huang1, Chia-Pin Lin1, Victor Chien-Chia Wu1, Yi-Wei Kao4,5, Hou-Yu Chiang1,6,7, Pao-Hsien Chu1,2,8,*
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1
Division of Cardiology, Chang Gung Memorial Hospital Linkou Medical Center, 333423 Taoyuan, Taiwan
2
Healthcare Center, Taoyuan Chang Gung Memorial Hospital, 333008 Taoyuan, Taiwan
3
Department of Internal Medicine, Taoyuan Chang Gung Memorial Hospital, 333008 Taoyuan, Taiwan
4
Department of Applied Statistics and Information Science, Ming Chuan University, 333321 Taoyuan, Taiwan
5
Artificial Intelligence Development Center, Fu Jen Catholic University, 242062 New Taipei City, Taiwan
6
Department of anatomy, College of Medicine, Chang Gung University, 333323 Taoyuan, Taiwan
7
Graduate Institute of Biomedical Sciences, Chang Gung University, 333323 Taoyuan, Taiwan
8
Heart Failure Center, Chang Gung Memorial Hospital Linkou Medical Center, 333423 Taoyuan, Taiwan
*Correspondence: taipei.chu@gmail.com (Pao-Hsien Chu)
Rev. Cardiovasc. Med. 2023, 24(8), 225;
https://doi.org/10.31083/j.rcm2408225
Submitted: 20 March 2023 | Revised: 27 June 2023 | Accepted: 30 June 2023 | Published: 8 August 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract
Keywords
adult congenital heart disease
atrial fibrillation
ischemic stroke
anticoagulation
CHA2DS2-VASc score
Graphical Abstract
Funding
CMRPG5H0221/Chang Gung Memorial Hospital
CMRPG5K0161/Chang Gung Memorial Hospital
111-2314-B-182A-013-MY3/Taiwan’s National Science and Technology Council (NSC)
Figures
Fig. 1.