{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:21:34Z","timestamp":1774581694984,"version":"3.50.1"},"reference-count":43,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Advances"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1016\/j.jacadv.2025.101898","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T17:48:13Z","timestamp":1750268893000},"page":"101898","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Incidence of Stroke in Adults With Congenital Heart Disease"],"prefix":"10.1016","volume":"4","author":[{"given":"Amanda E.","family":"Bilski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Kochav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greer","family":"Waldrop","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gular","family":"Mammadli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehriban","family":"Sariyeva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Argenio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua Z.","family":"Willey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinwe","family":"Ibeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlon","family":"Rosenbaum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza C.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.jacadv.2025.101898_bib1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/ije\/dyz009","article-title":"Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies","volume":"48","author":"Liu","year":"2019","journal-title":"Int J Epidemiol"},{"issue":"12","key":"10.1016\/j.jacadv.2025.101898_bib2","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J Am Coll Cardiol"},{"issue":"23","key":"10.1016\/j.jacadv.2025.101898_bib3","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000020593","article-title":"Incidence and mortality trend of congenital heart disease at the global, regional and national level, 1990-2017","volume":"99","author":"Wu","year":"2020","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"10.1016\/j.jacadv.2025.101898_bib4","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.hfc.2023.12.001","article-title":"Epidemiology and definition of heart failure in adults with congenital heart disease","volume":"20","author":"Ladouceur","year":"2024","journal-title":"Heart Failure Clinics"},{"key":"10.1016\/j.jacadv.2025.101898_bib5","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3389\/fneur.2019.00329","article-title":"Adults with complex congenital heart disease: cerebrovascular considerations for the neurologist","volume":"10","author":"Smith","year":"2019","journal-title":"Front Neurol"},{"key":"10.1016\/j.jacadv.2025.101898_bib6","article-title":"Stroke and systemic embolism in adult congenital heart disease","volume":"12","author":"Prok\u0161elj","year":"2023","journal-title":"Int J Cardiol Congenit Heart Dis"},{"issue":"2","key":"10.1016\/j.jacadv.2025.101898_bib7","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.115.003071","article-title":"Ischemic stroke in children and young adults with congenital heart disease","volume":"5","author":"Mandalenakis","year":"2016","journal-title":"J Am Heart Assoc"},{"issue":"15","key":"10.1016\/j.jacadv.2025.101898_bib8","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1136\/hrt.2010.196147","article-title":"Cerebrovascular accidents in adult patients with congenital heart disease","volume":"96","author":"Hoffmann","year":"2010","journal-title":"Heart"},{"issue":"13","key":"10.1016\/j.jacadv.2025.101898_bib9","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.020939","article-title":"Burden of ischemic stroke in patients with congenital heart disease: a nationwide, case-control study","volume":"10","author":"Giang","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jacadv.2025.101898_bib10","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S1052-3057(11)80002-9","article-title":"Risk of stroke in patients with congenital bicuspid valve","volume":"1","author":"Salgado","year":"1991","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"6","key":"10.1016\/j.jacadv.2025.101898_bib11","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1161\/01.CIR.87.6.1954","article-title":"Risk of stroke in adults with cyanotic congenital heart disease","volume":"87","author":"Perloff","year":"1993","journal-title":"Circulation"},{"issue":"3","key":"10.1016\/j.jacadv.2025.101898_bib12","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/S0735-1097(96)00196-9","article-title":"Cerebrovascular events in adult patients with cyanotic congenital heart disease","volume":"28","author":"Ammash","year":"1996","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"10.1016\/j.jacadv.2025.101898_bib13","first-page":"1066","article-title":"Characteristics of adult patients with atrial septal defects presenting with paradoxical embolism","volume":"74","author":"Bannan","year":"2009","journal-title":"Catheter Cardiovasc Interv"},{"issue":"4","key":"10.1016\/j.jacadv.2025.101898_bib14","first-page":"418","article-title":"Cardiovascular disease in late survivors of tetralogy of Fallot","volume":"40","author":"Bradley","year":"2013","journal-title":"Tex Heart Inst J"},{"key":"10.1016\/j.jacadv.2025.101898_bib15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/1471-2261-14-38","article-title":"Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan","volume":"14","author":"Lin","year":"2014","journal-title":"BMC Cardiovasc Dis"},{"key":"10.1016\/j.jacadv.2025.101898_bib16","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1136\/heartjnl-2014-306552","article-title":"Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure","volume":"101","author":"Nyboe","year":"2015","journal-title":"Heart"},{"issue":"4","key":"10.1016\/j.jacadv.2025.101898_bib17","first-page":"600","article-title":"Long-term outcome after transcatheter closure of atrial septal defect in older patients","volume":"8","author":"Takaya","year":"2015","journal-title":"JACC: Cardiovasc Interv"},{"issue":"5","key":"10.1016\/j.jacadv.2025.101898_bib18","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.amjcard.2015.05.052","article-title":"Risk of systemic hypertension and cerebrovascular accidents in patients with aortic coarctation aged <60 Years (from a National database study)","volume":"116","author":"Wu","year":"2015","journal-title":"Am J Cardiol"},{"issue":"25","key":"10.1016\/j.jacadv.2025.101898_bib19","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1161\/CIRCULATIONAHA.115.011241","article-title":"Stroke in adults with congenital heart disease: incidence, cumulative risk, and predictors","volume":"132","author":"Lanz","year":"2015","journal-title":"Circulation"},{"issue":"12","key":"10.1016\/j.jacadv.2025.101898_bib20","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1016\/j.jacc.2016.06.056","article-title":"Thrombotic and embolic complications associated with atrial arrhythmia after Fontan operation: role of prophylactic therapy","volume":"68","author":"Egbe","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"11","key":"10.1016\/j.jacadv.2025.101898_bib21","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.3346\/jkms.2016.31.11.1749","article-title":"Natural course of adult Ebstein anomaly when treated according to current recommendation","volume":"31","author":"Kim","year":"2016","journal-title":"J Korean Med Sci"},{"key":"10.1016\/j.jacadv.2025.101898_bib22","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ahj.2016.09.014","article-title":"Prevalence and outcome of thrombotic and embolic complications in adults after fontan operation","volume":"183","author":"Egbe","year":"2017","journal-title":"Am Heart J"},{"key":"10.1016\/j.jacadv.2025.101898_bib23","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ijcard.2017.02.004","article-title":"Increased risk of thromboembolic events in adult congenital heart disease patient with atrial tachyarrhythmias","volume":"234","author":"Masuda","year":"2017","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jacadv.2025.101898_bib24","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1136\/heartjnl-2017-311620","article-title":"Factors associated with coronary artery disease and stroke in adults with congenital heart disease","volume":"104","author":"Bokma","year":"2018","journal-title":"Heart"},{"key":"10.1016\/j.jacadv.2025.101898_bib25","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ijcard.2017.06.073","article-title":"Impact of atrial arrhythmias on outcome in adults with congenital heart disease","volume":"248","author":"Yang","year":"2017","journal-title":"Int J Cardiol"},{"issue":"16","key":"10.1016\/j.jacadv.2025.101898_bib26","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1161\/CIRCULATIONAHA.118.037064","article-title":"Substantial cardiovascular morbidity in adults with lower-complexity congenital heart disease","volume":"139","author":"Saha","year":"2019","journal-title":"Circulation"},{"issue":"15","key":"10.1016\/j.jacadv.2025.101898_bib27","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.118.011870","article-title":"Ischemic stroke in adults with congenital heart disease: a population-based cohort study","volume":"8","author":"Pedersen","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"6","key":"10.1016\/j.jacadv.2025.101898_bib28","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1093\/ejcts\/ezz259","article-title":"Surgical repair of aortic coarctation in adults: half a century of a single centre clinical experience","volume":"56","author":"Abjigitova","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"issue":"4","key":"10.1016\/j.jacadv.2025.101898_bib29","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.arcmed.2020.03.008","article-title":"Clinical spectrum and long-term outcome of 183 cases of ebstein's anomaly, experience of Mexican population","volume":"51","author":"Herrera-Bello","year":"2020","journal-title":"Arch Med Res"},{"issue":"2","key":"10.1016\/j.jacadv.2025.101898_bib30","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.hlc.2020.05.114","article-title":"Adult congenital heart disease survivors at age 50 Years: medical and psychosocial status","volume":"30","author":"Rehan","year":"2021","journal-title":"Heart Lung Circ"},{"issue":"23","key":"10.1016\/j.jacadv.2025.101898_bib31","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1136\/heartjnl-2021-319050","article-title":"Stroke in patients with secundum atrial septal defect and sequelae after transcatheter closure","volume":"107","author":"Dolgner","year":"2021","journal-title":"Heart"},{"issue":"22","key":"10.1016\/j.jacadv.2025.101898_bib32","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.121.023199","article-title":"Cardiovascular morbidity and mortality in adult patients with repaired aortic coarctation","volume":"10","author":"Meijs","year":"2021","journal-title":"J Am Heart Assoc"},{"issue":"6","key":"10.1016\/j.jacadv.2025.101898_bib33","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1002\/joa3.12630","article-title":"Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot","volume":"37","author":"Tsui","year":"2021","journal-title":"J Arrhythm"},{"issue":"7","key":"10.1016\/j.jacadv.2025.101898_bib34","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1007\/s00246-022-02890-4","article-title":"Assessment of hypertension, guideline-directed counseling, and outcomes in the ACHD population","volume":"43","author":"Jepson","year":"2022","journal-title":"Pediatr Cardiol"},{"issue":"12","key":"10.1016\/j.jacadv.2025.101898_bib35","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.3349\/ymj.2022.0111","article-title":"Major adverse cardiovascular events in Korean congenital heart disease patients: a nationwide age- and sex-matched case-control study","volume":"63","author":"Lee","year":"2022","journal-title":"Yonsei Med J"},{"issue":"7","key":"10.1016\/j.jacadv.2025.101898_bib36","first-page":"1111","article-title":"Long-term outcomes of adults with single ventricle physiology not undergoing Fontan repair: a multicentre experience","volume":"38","author":"Buend\u00eda-Fuentes","year":"2022","journal-title":"Can J Cardiol"},{"key":"10.1016\/j.jacadv.2025.101898_bib37","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Systematic Reviews"},{"issue":"5","key":"10.1016\/j.jacadv.2025.101898_bib38","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1161\/STROKEAHA.122.040073","article-title":"Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030","volume":"54","author":"Pu","year":"2023","journal-title":"Stroke"},{"key":"10.1016\/j.jacadv.2025.101898_bib39","first-page":"1463","article-title":"2018 AHA\/ACC guideline for the management of adults with congenital heart disease: executive summary: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"73","author":"Stout","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacadv.2025.101898_bib40","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1007\/s11606-007-0356-4","article-title":"Cyanotic congenital heart disease (CCHD) with symptomatic erythrocytosis","volume":"22","author":"Rose","year":"2007","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.jacadv.2025.101898_bib41","first-page":"841","article-title":"Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease","volume":"29","author":"Roche","year":"2013","journal-title":"Can J Cardiol"},{"key":"10.1016\/j.jacadv.2025.101898_bib42","doi-asserted-by":"crossref","first-page":"e146","DOI":"10.1161\/CIR.0000000000000485","article-title":"Heart disease and stroke statistics-2017 update: a report from the American heart association","volume":"135","author":"Benjamin","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2025.101898_bib43","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1161\/CIR.0000000000000204","article-title":"Congenital heart disease in the older adult: a scientific statement from the American heart association","volume":"131","author":"Bhatt","year":"2015","journal-title":"Circulation"}],"container-title":["JACC: Advances"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772963X25003187?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772963X25003187?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T02:14:44Z","timestamp":1774577684000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772963X25003187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":43,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["S2772963X25003187"],"URL":"https:\/\/doi.org\/10.1016\/j.jacadv.2025.101898","relation":{},"ISSN":["2772-963X"],"issn-type":[{"value":"2772-963X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Incidence of Stroke in Adults With Congenital Heart Disease","name":"articletitle","label":"Article Title"},{"value":"JACC: Advances","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacadv.2025.101898","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.","name":"copyright","label":"Copyright"}],"article-number":"101898"}}