Prescription of cardiovascular drugs in children with congenital heart defects in six European regions from 2000 to 2014: data from the EUROlinkCAT population-based cohort study

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BMJ open. 2022 Apr 21;12(4):e057400. doi:10.1136/bmjopen-2021-057400.

ABSTRACT

OBJECTIVES: Advances in surgical management strategies have significantly reduced mortality from congenital heart defects (CHDs). A decrease in infant mortality can be expected, which would consequently lead to greater morbidity in older children due to complications later in childhood and adolescence. This study aims to assess the use of cardiovascular medications (CVMs) as an indicator of disease burden in children born with coronary artery disease during the first 10 years of life.

DESIGN: Population-based cohort study.

BACKGROUND: Six population-based registries from the European Congenital Anomalies Surveillance Network (EUROCAT) participated. Data from live-born infants with major congenital anomalies (CA) born between 2000 and 2014 were linked to prescription databases. Four groups of children were analyzed: CA, CHD, severe CHD (sCHD) and ventricular septal defect (VSD) without sCHD. Liveborn infants without CA were included as a reference group.

PARTICIPANTS: We obtained data on 61,038 children born with AC, including 19,678 with CHD, 3,392 with sCHD, 12,728 children with VSD without sCHD, and 1,725,496 index children.

RESULTS: Children born with sCCH were most likely to receive a CVM prescription (42.9%, 95% CI 26.3 to 58.5) in the first year of life, compared to 13.3 % (6.7 to 22.0) of children with any coronary artery disease, 5.9% (3.7 to 8.7) of children with any CA and 0.1% (0. 0 to 0.1) of reference children. Medications were less likely to be prescribed after the first year of life for sCHD; 18.8% (14.8 to 23.1) for 1 to 4 year olds and 15.8% (12.0 to 20.1) for 5 to 9 year olds. Children with sCHD were most likely to receive a diuretic (36.4%, 18.6 to 54.5), an antihypertensive (6.9%, 3.7 to 11.3), or a beta-blocker ( 5.5%, 2.9 to 9.2).

CONCLUSION: Almost half of all children with sCHD were prescribed a CVM during their first year of life. For the four groups of children with abnormalities, the proportion of children with a CVM prescription decreased with age.

PMID:35450908 | DOI:10.1136/bmjopen-2021-057400