The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias

Anastasios Kartas; Andreas S Papazoglou; Diamantis Kosmidis; Dimitrios Moysidis; Amalia Baroutidou; Ioannis Doundoulakis; Stefanos Despotopoulos; Elena Vrana; Athanasios Koutsakis; George Rampidis; Despoina Ntiloudi; Sotiria Liori; Tereza Mousiama; Dimosthenis Avramidis; Sotiria Apostolopoulou; Alexandra Frogoudaki; Afrodite Tzifa; Haralambos Karvounis; George Giannakoulas

doi:10.20944/preprints202201.0406.v1

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preprints.org > medicine and pharmacology > cardiac and cardiovascular systems > doi: 10.20944/preprints202201.0406.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias

Stefanos Despotopoulos

Dimosthenis Avramidis

Sotiria Apostolopoulou

Version 1 : Received: 23 January 2022 / Approved: 27 January 2022 / Online: 27 January 2022 (03:22:27 CET)

A peer-reviewed article of this Preprint also exists.

Kartas, A.; Papazoglou, A.S.; Kosmidis, D.; Moysidis, D.V.; Baroutidou, A.; Doundoulakis, I.; Despotopoulos, S.; Vrana, E.; Koutsakis, A.; Rampidis, G.P.; Ntiloudi, D.; Liori, S.; Mousiama, T.; Avramidis, D.; Apostolopoulou, S.; Frogoudaki, A.; Tzifa, A.; Karvounis, H.; Giannakoulas, G. The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias. Diagnostics 2022, 12, 466. Kartas, A.; Papazoglou, A.S.; Kosmidis, D.; Moysidis, D.V.; Baroutidou, A.; Doundoulakis, I.; Despotopoulos, S.; Vrana, E.; Koutsakis, A.; Rampidis, G.P.; Ntiloudi, D.; Liori, S.; Mousiama, T.; Avramidis, D.; Apostolopoulou, S.; Frogoudaki, A.; Tzifa, A.; Karvounis, H.; Giannakoulas, G. The Adult Congenital Heart Disease Anatomic and Physiological Classification: Associations with Clinical Outcomes in Patients with Atrial Arrhythmias. Diagnostics 2022, 12, 466.

Abstract

The implications of the adult congenital heart disease anatomic and physiological classification (AP-ACHD) for risk assessment have not been adequately studied. A retrospective cohort study was conducted using data from an ongoing national, multicentre registry of patients with ACHD and atrial arrhythmias (AA) receiving apixaban (PROTECT-AR study, NCT03854149). At enrollment, patients were stratified according to Anatomic class (AnatC, range I to III) and physiological stage (PhyS, range B to D). Follow-up was conducted between May 2019 and September 2021. The primary outcome was a composite of death from any cause, any major thromboembolic event, major or clinically relevant non-major bleeding, or hospitalization. Cox proportional-hazards regression modeling was used to evaluate the risks for the outcome among AP-ACHD classes. Over a median 20-month follow-up period, 47 of 157 (29.9%) ACHD patients with AA experienced the composite outcome. Adjusted hazard ratios (aHR) with 95% confidence intervals [CI] for the outcome in PhyS C and PhyS D were 1.84 (95% CI 0.73 to 4.61) and 7.88 (95% CI 1.54 to 40.41) respectively, as compared with PhyS B. The corresponding aHRs in AnatC II and AnatC III were 1.10 (95% CI 0.39 to 3.06) and 0.99 (95% CI 0.24 to 4.10) respectively, as compared with AnatC I. In conclusion, the PhyS component of the AP-ACHD classification was an independent predictor of net adverse clinical events among ACHD patients with AA receiving apixaban.

Keywords

Atrial Arrhythmia; ACHD; Congenital Heart Disease; AP-ACHD classification; Mortality; Morbidity

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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