In the general population, certain the characteristics and conditions such as older age, hypertension, hypecholestolaemia, obesity, diabetes mellitus, family history of coronary heart disease, lack of exercise and smoking are associated with a higher risk of developing coronary artery disease. Until recently, patients born with cardiac malformations had limited life expectancy due to the complexity of their disorders and the lack of adequate treatment. Recent advances in medicine have prolonged the duration of their life. The number of patients with congenital heart diseases who reach adulthood has gradually increased and as they become older, their risk of developing coronary artery disease is expected to increase.
We aim to investigate what factors increase the risk of coronary artery disease in patients with congenital heart malformations and to compare their risks of death and of cardiovascular disease development with the risks of the general population. The results of this study are expected to add valuable information on whether patients with congenital heart disease require a different diagnostic, monitoring and treatment approach compared to the general population.
The population of Adult Congenital Heart Disease (ACHD) patients presents with specific characteristics. There are multiple factors that may contribute to the development of Coronary Artery Disease (CAD) in these patients. Among them, the presence of abnormalities in the repaired or non repaired coronary arteries, the presence of endothelial dysfunction previously documented in patients with cyanotic congenital disorders, or associated conditions such as hypertension.
The aim of this study is to demonstrate the possible differences in the risk of developing CAD, the prognosis and the survival of ACHD population as compared to non ACHD population. Additionally, it will answer the question whether the already established risk models for CAD can be effectively used to assess the cardiovascular risks in the population of ACHD patients, opening the way for further research in this not extensively study area.
Michael A Gatzoulis - Chief Investigator - Royal Brompton Hospital
Maria Boutsikou - Corresponding Applicant - Royal Brompton Hospital
Aleksander Kempny - Collaborator - Royal Brompton Hospital
Arturo Gonzalez-Izquierdo - Collaborator - University College London ( UCL )
George Giannakoulas - Collaborator - Aristotle University of Thessaloniki, Greece
Harry Hemingway - Collaborator - University College London ( UCL )
Konstantinos Dimopoulos - Collaborator - Royal Brompton Hospital
Mar Pujades Rodriguez - Collaborator - University of Leeds
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Patient Level Townsend Score;Practice Level Index of Multiple Deprivation;MINAP