Open AccessCongenital Heart Disease and Risk of Cardiovascular Disease: A Meta‐Analysis of Cohort Studies
Author(s) -
Wang Tingting,
Chen Lizhang,
Yang Tubao,
Huang Peng,
Wang Lesan,
Zhao Lijuan,
Zhang Senmao,
Ye Ziwei,
Chen Letao,
Zheng Zan,
Qin Jiabi
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.012030
Subject(s) - medicine , meta analysis , cohort study , stroke (engine) , confounding , cohort , relative risk , risk factor , heart failure , coronary artery disease , disease , cardiology , confidence interval , mechanical engineering , engineering
Background Despite remarkable success in the surgical and medical management of congenital heart disease ( CHD ), some survivors still experience cardiovascular complications over the long term. The goal of this study was to evaluate the association between CHD and risk of cardiovascular disease ( CVD ) by conducting a meta‐analysis of cohort studies. Methods and Results A systematic literature search of several databases was conducted through April 2018 to identify studies reporting the risk of CVD , stroke, heart failure, and coronary artery heart disease in CHD survivors. The quality of individual studies was assessed using the Newcastle‐Ottawa scale. The overall risk estimates were pooled using fixed‐effects meta‐analysis. Subgroup analyses were performed to explore possible sources of heterogeneity. Nine cohort studies comprising 684 200 participants were included. The overall combined relative risks for people with CHD compared with the controls were 3.12 (95% CI, 3.01–3.24) for CVD , 2.46 (95% CI, 2.30–2.63) for stroke, 5.89 (95% CI, 5.58–6.21) for heart failure, and 1.50 (95% CI, 1.40–1.61) for coronary artery heart disease. Significant heterogeneity was detected across studies regarding these risk estimates. Heterogeneity in the risk estimate of CVD was explained by geographic region, type of study design, sample source, age composition, and controlled confounders. Conclusions This meta‐analysis of cohort studies of CHD found an association of increased risk of CVD in later life, although we cannot determine whether this association is confounded by a risk factor profile of CVD among CHD survivors or whether CHD is an independent risk factor.