Coronary Artery Disease in Adults With Coarctation of Aorta: Incidence, Risk Factors, and Outcomes

Alexander Egbe, Charanjit Rihal, Alexa Thomas, Amber Boler, Nandini Mehra, Kylie Andersen, Srikanth Kothapalli, Nathaniel W. Taggart, Heidi M. Connolly

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3 Scopus citations

Abstract

Background Premature coronary artery disease ( CAD ) is common in patients with coarctation of aorta ( COA ), but there are limited data about any direct relationship (or lack thereof) between COA and CAD . We hypothesized that atherosclerotic cardiovascular disease risk factors, rather than COA diagnosis, was the primary determinant of CAD occurrence in patients with COA . Methods and Results This is a retrospective study of 654 COA patients and a control group of 876 patients with valvular pulmonic stenosis and tetralogy of Fallot to determine prevalence and independent risk factors for CAD . There was no evidence of a difference in the unadjusted CAD prevalence between the COA and control groups (7.8% versus 6.3%, P=0.247), but premature CAD was more common in COA patients (4.4% versus 1.8%, P=0.002). In the analysis of a propensity-matched cohort of 126 COA and 126 control patients, there was no evidence of a difference in overall CAD prevalence (6.3% versus 5.6% versus P=0.742) and premature CAD prevalence (4.8% versus 3.2%, P=0.518). The multivariable risk factors for CAD were hypertension (odds ratio [ OR ] 2.14; 95% CI 1.36-3.38), hyperlipidemia ( OR 3.33; 95% CI 2.02-5.47), diabetes mellitus ( OR 1.98; 95% CI 1.31-3.61), male sex ( OR 2.05; 95% CI 1.33-3.17), and older age per year ( OR 1.06; 95% CI 1.04-1.07). Conclusions After adjusting for atherosclerotic cardiovascular disease risk factors, we did not find evidence of a difference in CAD risk between the patients with COA and other patients with congenital heart disease.

Original languageEnglish (US)
Pages (from-to)e012056
JournalJournal of the American Heart Association
Volume8
Issue number12
DOIs
StatePublished - Jun 18 2019

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Keywords

  • cardiovascular disease
  • coarctation
  • coronary artery disease
  • mortality
  • risk modification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Egbe, A., Rihal, C., Thomas, A., Boler, A., Mehra, N., Andersen, K., Kothapalli, S., Taggart, N. W., & Connolly, H. M. (2019). Coronary Artery Disease in Adults With Coarctation of Aorta: Incidence, Risk Factors, and Outcomes. Journal of the American Heart Association, 8(12), e012056. https://doi.org/10.1161/JAHA.119.012056