Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot

Abstract Background Adults with repaired Tetralogy of Fallot (rTOF) comprise one of the largest cohorts among adults with congenital heart disease (ACHD). These patients have a higher burden of atrial arrhythmias (AA), leading to increased adverse events, including stroke and transient ischemic atta...

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Autores principales:	Clara Tsui, Darryl Wan, Jasmine Grewal, Marla Kiess, Amanda Barlow, Derek Human, Santabhanu Chakrabarti
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	atrial arrhythmia congenital heart disease tetralogy of Fallot thromboembolic events Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f040a04bde534ddb9de1386778b968c9
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spelling	oai:doaj.org-article:f040a04bde534ddb9de1386778b968c92021-12-02T08:25:11ZIncreasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot1883-21481880-427610.1002/joa3.12630https://doaj.org/article/f040a04bde534ddb9de1386778b968c92021-12-01T00:00:00Zhttps://doi.org/10.1002/joa3.12630https://doaj.org/toc/1880-4276https://doaj.org/toc/1883-2148Abstract Background Adults with repaired Tetralogy of Fallot (rTOF) comprise one of the largest cohorts among adults with congenital heart disease (ACHD). These patients have a higher burden of atrial arrhythmias (AA), leading to increased adverse events, including stroke and transient ischemic attack (TIA). However, the data on factors associated with stroke/TIA in rTOF are limited, and classic risk factors may not apply. We studied event rates and associated factors for thromboembolism in a rTOF cohort. Methods Retrospective cohort study of all adult patients age >18 years with rTOF followed at a single ACHD tertiary care center. AA of interest were atrial fibrillation (AF) and atrial flutter (AFL). Results Data from 260 patients were identified, mean age 37.6 SD 13.3 years, followed over 5108 patient‐years (mean 16.6 SD 8.2 years). 43 patients had AF and/or AFL, and 30 patients had thromboembolic events, of which 19 patients had stroke/TIA. The event rate for any thromboembolism was 3.39 per 100 patient‐years follow‐up in patients with AA, compared to 1.80 in patients without (P = .07). In univariate analysis, older age and diabetes were associated with thromboembolic events. In multivariate analysis, only older age was associated with thromboembolic events. Conclusions In our relatively young cohort of adults with rTOF, there was a high prevalence of AA, associated with nearly double the rate of thromboembolic events compared to patients without AA. Older age alone is independently associated with thromboembolic events. Further studies into assessment of silent AA are required, and routine assessments should be considered at an earlier age.Clara TsuiDarryl WanJasmine GrewalMarla KiessAmanda BarlowDerek HumanSantabhanu ChakrabartiWileyarticleatrial arrhythmiacongenital heart diseasetetralogy of Fallotthromboembolic eventsDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Arrhythmia, Vol 37, Iss 6, Pp 1546-1554 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial arrhythmia congenital heart disease tetralogy of Fallot thromboembolic events Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atrial arrhythmia congenital heart disease tetralogy of Fallot thromboembolic events Diseases of the circulatory (Cardiovascular) system RC666-701 Clara Tsui Darryl Wan Jasmine Grewal Marla Kiess Amanda Barlow Derek Human Santabhanu Chakrabarti Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
description	Abstract Background Adults with repaired Tetralogy of Fallot (rTOF) comprise one of the largest cohorts among adults with congenital heart disease (ACHD). These patients have a higher burden of atrial arrhythmias (AA), leading to increased adverse events, including stroke and transient ischemic attack (TIA). However, the data on factors associated with stroke/TIA in rTOF are limited, and classic risk factors may not apply. We studied event rates and associated factors for thromboembolism in a rTOF cohort. Methods Retrospective cohort study of all adult patients age >18 years with rTOF followed at a single ACHD tertiary care center. AA of interest were atrial fibrillation (AF) and atrial flutter (AFL). Results Data from 260 patients were identified, mean age 37.6 SD 13.3 years, followed over 5108 patient‐years (mean 16.6 SD 8.2 years). 43 patients had AF and/or AFL, and 30 patients had thromboembolic events, of which 19 patients had stroke/TIA. The event rate for any thromboembolism was 3.39 per 100 patient‐years follow‐up in patients with AA, compared to 1.80 in patients without (P = .07). In univariate analysis, older age and diabetes were associated with thromboembolic events. In multivariate analysis, only older age was associated with thromboembolic events. Conclusions In our relatively young cohort of adults with rTOF, there was a high prevalence of AA, associated with nearly double the rate of thromboembolic events compared to patients without AA. Older age alone is independently associated with thromboembolic events. Further studies into assessment of silent AA are required, and routine assessments should be considered at an earlier age.
format	article
author	Clara Tsui Darryl Wan Jasmine Grewal Marla Kiess Amanda Barlow Derek Human Santabhanu Chakrabarti
author_facet	Clara Tsui Darryl Wan Jasmine Grewal Marla Kiess Amanda Barlow Derek Human Santabhanu Chakrabarti
author_sort	Clara Tsui
title	Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
title_short	Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
title_full	Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
title_fullStr	Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
title_full_unstemmed	Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
title_sort	increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of fallot
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/f040a04bde534ddb9de1386778b968c9
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Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot

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