{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:52:02Z","timestamp":1793137922761,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,11,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The long\u2010term burden of cardiovascular disease after repair of coarctation of the aorta (CoA) has not been elucidated. We aimed to determine the incidence of and risk factors for cardiovascular events in adult patients with repaired CoA. Additionally, mortality rates were compared between adults with repaired CoA and the general population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the Dutch Congenital Corvitia (CONCOR) registry, patients aged \u226516\u00a0years with previous surgical or transcatheter CoA repair from 5 tertiary referral centers were included. Cardiovascular events were recorded, comprising coronary artery disease, stroke\/transient ischemic attack, aortic complications, arrhythmias, heart failure hospitalizations, endocarditis, and cardiovascular death. In total, 920 patients (median age, 24\u00a0years [range 16\u201374\u00a0years]) were included. After a mean follow\u2010up of 9.3\u00b15.1\u00a0years, 191 patients (21%) experienced at least 1 cardiovascular event. A total of 270 cardiovascular events occurred, of which aortic complications and arrhythmias were most frequent. Older age at initial CoA repair (hazard ratio [HR], 1.017; 95% CI, 1.000\u20131.033 [\n              <jats:italic>P<\/jats:italic>\n              =0.048]) and elevated left ventricular mass index (HR, 1.009; 95% CI, 1.005\u20131.013 [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001]) were independently associated with an increased risk of cardiovascular events. The mortality rate was 3.3 times higher than expected based on an age\u2010 and sex\u2010matched cohort from the Dutch general population (standardized mortality ratio, 3.3; 95% CI, 2.3\u20134.4 [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This large, prospective cohort of adults with repaired CoA showed a high burden of cardiovascular events, particularly aortic complications and arrhythmias, during long\u2010term follow\u2010up. Older age at initial CoA repair and elevated left ventricular mass index were independent risk factors for the occurrence of cardiovascular events. Mortality was 3.3\u2010fold higher compared with the general population. These results advocate stringent follow\u2010up after CoA repair and emphasize the need for improved preventive strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023199","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T10:06:05Z","timestamp":1636538765000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Cardiovascular Morbidity and Mortality in Adult Patients With Repaired Aortic Coarctation"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-996X","authenticated-orcid":false,"given":"Timion A.","family":"Meijs","sequence":"first","affiliation":[{"name":"Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savine C. S.","family":"Minderhoud","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2674-8709","authenticated-orcid":false,"given":"Steven A.","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbert J.","family":"de Winter","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC, Location Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J. M.","family":"Mulder","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC, Location Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost P.","family":"van Melle","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke S.","family":"Hoendermis","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie P. J.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaas P. A.","family":"Zuithoff","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Julius Center for Health Sciences and Primary Care Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-3181","authenticated-orcid":false,"given":"Gregor J.","family":"Krings","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Wilhelmina Children\u2019s Hospital Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-7169","authenticated-orcid":false,"given":"Pieter A.","family":"Doevendans","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands"},{"name":"Department of Cardiology Central Military Hospital Utrecht The Netherlands"},{"name":"Netherlands Heart Institute Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6099-7111","authenticated-orcid":false,"given":"Maarten","family":"Witsenburg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6770-3830","authenticated-orcid":false,"given":"Jolien W.","family":"Roos\u2010Hesselink","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemien E.","family":"van den Bosch","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1433-9692","authenticated-orcid":false,"given":"Berto J.","family":"Bouma","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC, Location Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Voskuil","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v7.i11.765"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.03.056"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000603"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.80.4.840"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-307035"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009072"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.062"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.06.016"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15026"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2015.05.002"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181d4739e"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033502"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.11.164"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.04.027"},{"key":"e_1_3_2_16_2","first-page":"1190","article-title":"Long\u2010term mortality and cardiovascular burden for adult survivors of coarctation of the aorta","volume":"105","author":"Lee MGY","year":"2019","unstructured":"Lee MGY, Babu\u2010Narayan SV, Kempny A, Uebing A, Montanaro C, Shore DF, d'Udekem Y, Gatzoulis MA. 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