Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation
Background Risk stratification for adults with congenital heart disease is usually based on the anatomic complexity of the patients’ defect. The 2018 American Heart Association/American College of Cardiology guidelines for the management of adults with congenital heart disease proposed a new classif...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.014988 |
| _version_ | 1797607819593121792 |
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| author | Fouke Ombelet Eva Goossens Alexander Van De Bruaene Werner Budts Philip Moons |
| author_facet | Fouke Ombelet Eva Goossens Alexander Van De Bruaene Werner Budts Philip Moons |
| author_sort | Fouke Ombelet |
| collection | DOAJ |
| description | Background Risk stratification for adults with congenital heart disease is usually based on the anatomic complexity of the patients’ defect. The 2018 American Heart Association/American College of Cardiology guidelines for the management of adults with congenital heart disease proposed a new classification scheme, combining anatomic complexity and current physiological stage of the patient. We aimed to investigate the capacity of the Adult Congenital Heart Disease Anatomic and Physiological classification to predict 15‐year mortality. Methods and Results Data on 5 classification systems were collected for 629 patients at the outpatient clinic for a previous study. After 15 years, data on mortality were obtained through medical record review. For this assessment, we additionally collected information on physiological state to determine the Adult Congenital Heart Disease Anatomic and Physiological classification. Harrell's concordance statistics index, obtained through a univariate Cox proportional hazards regression, was 0.71 (95% CI, 0.63−0.78) for the Adult Congenital Heart Disease Anatomic and Physiological classification. Harrell's concordance statistics index of the congenital heart disease anatomic component only was 0.67 (95% CI, 0.60−0.74). The highest Harrell's concordance statistics index was obtained for the anatomic complexity in combination with the Congenital Heart Disease Functional Index (0.79; 95% CI, 0.73–0.84). Conclusions This first investigation of the Adult Congenital Heart Disease Anatomic and Physiological classification system provides empirical support for adding the physiological component to the anatomic complexity in the prediction of 15‐year cardiac mortality. |
| first_indexed | 2024-03-11T05:35:02Z |
| format | Article |
| id | doaj.art-8d7cf9ae4c554ef8bc478144930315c4 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-11T05:35:02Z |
| publishDate | 2020-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-8d7cf9ae4c554ef8bc478144930315c42023-11-17T16:50:53ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-03-019510.1161/JAHA.119.014988Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity EvaluationFouke Ombelet0Eva Goossens1Alexander Van De Bruaene2Werner Budts3Philip Moons4KU Leuven Department of Public Health and Primary Care KU Leuven–University of Leuven 3000‐B Leuven BelgiumKU Leuven Department of Public Health and Primary Care KU Leuven–University of Leuven 3000‐B Leuven BelgiumKU Leuven Department of Cardiovascular Sciences KU Leuven–University of Leuven 3000‐B Leuven BelgiumKU Leuven Department of Cardiovascular Sciences KU Leuven–University of Leuven 3000‐B Leuven BelgiumKU Leuven Department of Public Health and Primary Care KU Leuven–University of Leuven 3000‐B Leuven BelgiumBackground Risk stratification for adults with congenital heart disease is usually based on the anatomic complexity of the patients’ defect. The 2018 American Heart Association/American College of Cardiology guidelines for the management of adults with congenital heart disease proposed a new classification scheme, combining anatomic complexity and current physiological stage of the patient. We aimed to investigate the capacity of the Adult Congenital Heart Disease Anatomic and Physiological classification to predict 15‐year mortality. Methods and Results Data on 5 classification systems were collected for 629 patients at the outpatient clinic for a previous study. After 15 years, data on mortality were obtained through medical record review. For this assessment, we additionally collected information on physiological state to determine the Adult Congenital Heart Disease Anatomic and Physiological classification. Harrell's concordance statistics index, obtained through a univariate Cox proportional hazards regression, was 0.71 (95% CI, 0.63−0.78) for the Adult Congenital Heart Disease Anatomic and Physiological classification. Harrell's concordance statistics index of the congenital heart disease anatomic component only was 0.67 (95% CI, 0.60−0.74). The highest Harrell's concordance statistics index was obtained for the anatomic complexity in combination with the Congenital Heart Disease Functional Index (0.79; 95% CI, 0.73–0.84). Conclusions This first investigation of the Adult Congenital Heart Disease Anatomic and Physiological classification system provides empirical support for adding the physiological component to the anatomic complexity in the prediction of 15‐year cardiac mortality.https://www.ahajournals.org/doi/10.1161/JAHA.119.014988congenital heart diseaseclassificationmortality |
| spellingShingle | Fouke Ombelet Eva Goossens Alexander Van De Bruaene Werner Budts Philip Moons Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease congenital heart disease classification mortality |
| title | Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation |
| title_full | Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation |
| title_fullStr | Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation |
| title_full_unstemmed | Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation |
| title_short | Newly Developed Adult Congenital Heart Disease Anatomic and Physiological Classification: First Predictive Validity Evaluation |
| title_sort | newly developed adult congenital heart disease anatomic and physiological classification first predictive validity evaluation |
| topic | congenital heart disease classification mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.014988 |
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