RESULTS FROM THE WISH-ACHD STUDY: WOMEN'S INITIATIVE IN THE STUDY OF HOSPITALIZATIONS IN ADULT CONGENITAL HEART DISEASE

Abstract

Background: Hospital outcomes in women with adult congenital heart disease (ACHD) are poorly understood. We aimed to define cardiovascular risk factors (CVRF) and major adverse cardiovascular events (MACE) in ACHD. Methods: Men and women with ACHD ≥18 years old in the National Inpatient Sample (2003-2014) were analyzed to determine rates of CVRF (smoking, obesity, hyperlipidemia, atrial fibrillation and futter, ventricular fibrillation, hypertension, myocardial infarction, coronary artery disease) and MACE (mortality, heart failure, arrhythmia, stroke). Results: There were 106,743 total ACHD admissions analyzed during the study timeframe with CVRF coded 181,246 times and MACE 106,941 times. Women and men had similar rates of simple (24% vs 18%) and moderate-severely (mod-severe) complex ACHD (47% vs 38%) (Fig 1A). Women with ACHD were less likely than men to have CVRF (p<0.001) except for obesity (p<0.0001) (Fig 1B). MACE were signifcantly higher in women with mod-severe ACHD (p<0.01 mortality; p<0.001 for other MACE) (Fig 1C). However, MACE were signifcantly lower for women with mild ACHD (p<0.01 for mortality; p<0.001 for other MACE) (Fig 1D). Pregnant women had less MACE than non-pregnant women (p<0.001) (Fig 1E); labor and delivery admissions did not impact MACE prevalence. Conclusion: Hospitalized women with mild ACHD have fewer traditional CVRF and MACE compared to men. However, women with mod-severely complex CHD had more MACE than men, a finding that was not impacted by pregnancy status.