Kuijpers Joey M, van der Bom Teun, van Riel Annelieke C M J, Meijboom Folkert J, van Dijk Arie P J, Pieper Petronella G, Vliegen Hubert W, Waskowsky W Marc, Oomen Toon, Zomer A Carla, Wagenaar Lodewijk J, Heesen Wilfred F, Roos-Hesselink Jolien W, Zwinderman Aeilko H, Mulder Barbara J M, Bouma Berto J
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands Interuniversity Cardiology Institute of the Netherlands - Netherlands Heart Institute, Utrecht, The Netherlands.
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Eur Heart J. 2015 Aug 14;36(31):2079-2086. doi: 10.1093/eurheartj/ehv097. Epub 2015 Apr 16.
The identification of sex differences in the prognosis of adults with a secundum atrial septal defect (ASD2) could help tailor their clinical management, as it has in other cardiovascular diseases. We investigated whether disparity between the sexes exists in long-term outcome of adult ASD2 patients.
Patients with ASD2 classified as the primary defect were selected from the Dutch national registry of adult congenital heart disease. Survival stratified by sex was compared with a sex-matched general population. In a total of 2207 adult patients (mean age at inclusion 44.8 years, 33.0% male), 102 deaths occurred during a cumulative follow-up of 13 584 patient-years. Median survival was 79.7 years for men and 85.6 years for women with ASD2. Compared with the age- and sex-matched general population, survival was lower for male, but equal for female patients (P = 0.015 and 0.766, respectively). Logistic regression analyses showed that men had a higher risk of conduction disturbances (OR = 1.63; 95% CI, 1.22-2.17) supraventricular dysrhythmias (OR = 1.41; 1.12-1.77), cerebrovascular thromboembolic events (OR = 1.53; 1.10-2.12), and heart failure (OR = 1.91; 1.06-3.43).
In contrast to women, adult men with an ASD2 have worse survival than a sex-matched general population. Male patients also have a greater risk of morbidity during adult life. Sex disparity in survival and morbidity suggests the need for a sex-specific clinical approach towards these patients.
