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Haemorrhagic stroke risk greater in CHD patients vs general population

17 May 2018

Children and young adults with congenital heart disease (CHD), particularly nonconotruncal defects and coarctation of the aorta, are about eight times as likely as those in the general population to develop haemorrhagic stroke, although the absolute risk appears to be low, according to a study.

Researchers drew data from the Swedish Patient Register and identified 21,982 patients who were born with a diagnosis of CHD. Each patient was matched with 10 randomly selected controls from the general population, matched for age, sex and county.

Of the CHD patients, 70 developed intracerebral haemorrhage (ICH) and 57 developed subarachnoid haemorrhage (SAH) up to the age of 42 years. CHD patients had about an eightfold greater risk of developing ICH (incidence rate ratio, 8.23; 95 percent CI, 6–11.2) and SAH (incidence rate ratio, 7.64; 5.41–10.7) compared with controls.

However, the absolute risk of ICH and SAH was low, with incidence rates of 1.18 and 0.96 cases per 10,000 person-years, respectively.

The highest relative risk of developing haemorrhagic stroke was observed in patients with severe nonconotruncal defects (incidence rate ratio, 16.5; 5.63–51.2) or coarctation of the aorta (incidence rate ratio, 17.3; 6.63–51.8), with respective incidence rates of 3.22 and 2.79 cases per 10,000 person-years.

The present data underscore the complexity and heterogeneity of CHD. Researchers noted that the number of haemorrhagic stroke events was limited despite using nationwide registers that include all CHD patients for an entire nation.

Additional studies are warranted to examine mechanisms and prevention strategies for haemorrhagic stroke among CHD patients, researchers added.

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