Secundum atrial septal defect is associated with reduced survival in adult men

JM Kuijpers, T van der Bom, ACMJ van Riel, FJ (Folkert) Meijboom, APJ van Dijk, PG Pieper, HW Vliegen, WM Waskowsky, T (Toon) Oomen, AC Zomer, LJ Wagenaar, WF Heesen, Jolien Roos - Hesselink, AH Zwinderman, BJM Mulder, BJ Bouma

Research output: Contribution to journalArticleAcademicpeer-review

33 Citations (Scopus)


Aims The identification of sex differences in the prognosis of adults with a secundum atrial septal defect (ASD2) could help tailor their clinical management, as it has in other cardiovascular diseases. We investigated whether disparity between the sexes exists in long-term outcome of adult ASD2 patients. Methods and results Patients with ASD2 classified as the primary defect were selected from the Dutch national registry of adult congenital heart disease. Survival stratified by sex was compared with a sex-matched general population. In a total of 2207 adult patients (mean age at inclusion 44.8 years, 33.0% male), 102 deaths occurred during a cumulative follow-up of 13 584 patient-years. Median survival was 79.7 years for men and 85.6 years for women with ASD2. Compared with the ageand sex-matched general population, survival was lower for male, but equal for female patients (P = 0.015 and 0.766, respectively). Logistic regression analyses showed that men had a higher risk of conduction disturbances (OR = 1.63; 95% CI, 1.22-2.17) supraventricular dysrhythmias (OR = 1.41; 1.12-1.77), cerebrovascular thromboembolic events (OR = 1.53; 1.10-2.12), and heart failure (OR = 1.91; 1.06-3.43). Conclusion In contrast to women, adult men with an ASD2 have worse survival than a sex-matched general population. Male patients also have a greater risk of morbidity during adult life. Sex disparity in survival and morbidity suggests the need for a sex-specific clinical approach towards these patients.
Original languageUndefined/Unknown
Pages (from-to)2079-2086
Number of pages8
JournalEuropean Heart Journal
Issue number31
Publication statusPublished - 2015

Research programs

  • EMC COEUR-09

Cite this