Abstract 14712: The Risk of Congestive Heart Failure in Children and Young Adults With Congenital Heart Disease in Sweden

Introduction: Patients with congenital heart disease (CHD) have an increased life expectancy during the last decades because of the improvement in pediatric care. However, increased admission to the hospitals due to congestive heart failure (CHF) in patients with CHD has been reported recently. Hypothesis: The aim of the present study was to estimate the risk of developing CHF in children and young adults with CHD compared to matched controls. Methods: We used data from the Swedish Patient and Cause of Death Registers to include all patients with a CHD diagnosis who were born between 1970 and 1993. Diagnoses were coded according to the International Classification of Diseases (ICD 8th, 9th, and 10th editions). Follow-up and comorbidity data were collected until 2011. Each patient with CHD was matched by age, sex, and county with 10 controls from the Total Population Register in Sweden. Results: Among 26,906 patients (51.3 % men) with CHD and 269,053 matched controls, 675 and 449, respectively, were hospitalized with CHF; the mean follow-up was 18.5 years. The risk to develop CHF among CHD patients was 91.1 times greater (95% [CI] 53.4-155.6, p<0.001) compared to controls. CHD patients born in 1970s had a hazard ratio (HR) of 25.1 (95% [CI] 9.5-66.0, p<0.001) to develop CHF, in 1980s the HR was 102.6 (95% [CI] 47.1-223.4, p<0.001) and for those born in the beginning of 1990s was 246.7 (95% [CI] 60.0-1015.0, p<0.001). Conclusions: The absolute risk to develop CHF in children and young adults with CHD was low; however, the relative risk was almost 90 times higher compared to matched controls. The risk increased exponentially with subsequent birth decade, probably due to the increased chances for survival. Further studies are indicated in order to determine the underlying mechanisms of CHF and in that case possible prevention or early treatment.