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The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias
The implications of the adult congenital heart disease anatomic and physiological classification (AP-ACHD) for risk assessment have not been adequately studied. A retrospective cohort study was conducted using data from an ongoing national, multicentre registry of patients with ACHD and atrial arrhy...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870966/ https://www.ncbi.nlm.nih.gov/pubmed/35204557 http://dx.doi.org/10.3390/diagnostics12020466 |
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author | Kartas, Anastasios Papazoglou, Andreas S. Kosmidis, Diamantis Moysidis, Dimitrios V. Baroutidou, Amalia Doundoulakis, Ioannis Despotopoulos, Stefanos Vrana, Elena Koutsakis, Athanasios Rampidis, Georgios P. Ntiloudi, Despoina Liori, Sotiria Mousiama, Tereza Avramidis, Dimosthenis Apostolopoulou, Sotiria Frogoudaki, Alexandra Tzifa, Afrodite Karvounis, Haralambos Giannakoulas, George |
author_facet | Kartas, Anastasios Papazoglou, Andreas S. Kosmidis, Diamantis Moysidis, Dimitrios V. Baroutidou, Amalia Doundoulakis, Ioannis Despotopoulos, Stefanos Vrana, Elena Koutsakis, Athanasios Rampidis, Georgios P. Ntiloudi, Despoina Liori, Sotiria Mousiama, Tereza Avramidis, Dimosthenis Apostolopoulou, Sotiria Frogoudaki, Alexandra Tzifa, Afrodite Karvounis, Haralambos Giannakoulas, George |
author_sort | Kartas, Anastasios |
collection | PubMed |
description | The implications of the adult congenital heart disease anatomic and physiological classification (AP-ACHD) for risk assessment have not been adequately studied. A retrospective cohort study was conducted using data from an ongoing national, multicentre registry of patients with ACHD and atrial arrhythmias (AA) receiving apixaban (PROTECT-AR study, NCT03854149). At enrollment, patients were stratified according to Anatomic class (AnatC, range I to III) and physiological stage (PhyS, range B to D). A follow-up was conducted between May 2019 and September 2021. The primary outcome was a composite of death from any cause, any major thromboembolic event, major or clinically relevant non-major bleeding, or hospitalization. Cox proportional-hazards regression modeling was used to evaluate the risks for the outcome among AP-ACHD classes. Over a median 20-month follow-up period, 47 of 157 (29.9%) ACHD patients with AA experienced the composite outcome. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for the outcome in PhyS C and PhyS D were 1.79 (95% CI 0.69 to 4.67) and 8.15 (95% CI 1.52 to 43.59), respectively, as compared with PhyS B. The corresponding aHRs in AnatC II and AnatC III were 1.12 (95% CI 0.37 to 3.41) and 1.06 (95% CI 0.24 to 4.63), respectively, as compared with AnatC I. In conclusion, the PhyS component of the AP-ACHD classification was an independent predictor of net adverse clinical events among ACHD patients with AA. |
format | Online Article Text |
id | pubmed-8870966 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88709662022-02-25 The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias Kartas, Anastasios Papazoglou, Andreas S. Kosmidis, Diamantis Moysidis, Dimitrios V. Baroutidou, Amalia Doundoulakis, Ioannis Despotopoulos, Stefanos Vrana, Elena Koutsakis, Athanasios Rampidis, Georgios P. Ntiloudi, Despoina Liori, Sotiria Mousiama, Tereza Avramidis, Dimosthenis Apostolopoulou, Sotiria Frogoudaki, Alexandra Tzifa, Afrodite Karvounis, Haralambos Giannakoulas, George Diagnostics (Basel) Article The implications of the adult congenital heart disease anatomic and physiological classification (AP-ACHD) for risk assessment have not been adequately studied. A retrospective cohort study was conducted using data from an ongoing national, multicentre registry of patients with ACHD and atrial arrhythmias (AA) receiving apixaban (PROTECT-AR study, NCT03854149). At enrollment, patients were stratified according to Anatomic class (AnatC, range I to III) and physiological stage (PhyS, range B to D). A follow-up was conducted between May 2019 and September 2021. The primary outcome was a composite of death from any cause, any major thromboembolic event, major or clinically relevant non-major bleeding, or hospitalization. Cox proportional-hazards regression modeling was used to evaluate the risks for the outcome among AP-ACHD classes. Over a median 20-month follow-up period, 47 of 157 (29.9%) ACHD patients with AA experienced the composite outcome. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for the outcome in PhyS C and PhyS D were 1.79 (95% CI 0.69 to 4.67) and 8.15 (95% CI 1.52 to 43.59), respectively, as compared with PhyS B. The corresponding aHRs in AnatC II and AnatC III were 1.12 (95% CI 0.37 to 3.41) and 1.06 (95% CI 0.24 to 4.63), respectively, as compared with AnatC I. In conclusion, the PhyS component of the AP-ACHD classification was an independent predictor of net adverse clinical events among ACHD patients with AA. MDPI 2022-02-11 /pmc/articles/PMC8870966/ /pubmed/35204557 http://dx.doi.org/10.3390/diagnostics12020466 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kartas, Anastasios Papazoglou, Andreas S. Kosmidis, Diamantis Moysidis, Dimitrios V. Baroutidou, Amalia Doundoulakis, Ioannis Despotopoulos, Stefanos Vrana, Elena Koutsakis, Athanasios Rampidis, Georgios P. Ntiloudi, Despoina Liori, Sotiria Mousiama, Tereza Avramidis, Dimosthenis Apostolopoulou, Sotiria Frogoudaki, Alexandra Tzifa, Afrodite Karvounis, Haralambos Giannakoulas, George The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias |
title | The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias |
title_full | The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias |
title_fullStr | The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias |
title_full_unstemmed | The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias |
title_short | The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias |
title_sort | adult congenital heart disease anatomic and physiological classification: associations with clinical outcomes in patients with atrial arrhythmias |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870966/ https://www.ncbi.nlm.nih.gov/pubmed/35204557 http://dx.doi.org/10.3390/diagnostics12020466 |
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