TY - JOUR
T1 - Red Flags for Maltese Adults with Congenital Heart Disease
T2 - Poorer Dental Care and Less Sports Participation Compared to Other European Patients—An APPROACH-IS Substudy
AU - On behalf of the APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD)
AU - Caruana, Maryanne
AU - Apers, Silke
AU - Kovacs, Adrienne H.
AU - Luyckx, Koen
AU - Thomet, Corina
AU - Budts, Werner
AU - Sluman, Maayke
AU - Eriksen, Katrine
AU - Dellborg, Mikael
AU - Berghammer, Malin
AU - Johansson, Bengt
AU - Soufi, Alexandra
AU - Callus, Edward
AU - Moons, Philip
AU - Grech, Victor
AU - Alday, Luis
AU - Maisuls, Héctor
AU - Vega, Betina
AU - Menahem, Samuel
AU - Eaton, Sarah
AU - Larion, Ruth
AU - Wang, Qi Feng
AU - Budts, Werner
AU - Van Deyk, Kristien
AU - Apers, Silke
AU - Goossens, Eva
AU - Rassart, Jessica
AU - Luyckx, Koen
AU - Moons, Philip
AU - Rempel, Gwen
AU - Mackie, Andrew
AU - Ballantyne, Ross
AU - Rankin, Kathryn
AU - Norris, Colleen
AU - Taylor, Dylan
AU - Vondermuhll, Isabelle
AU - Windram, Jonathan
AU - Heggie, Pamela
AU - Lasiuk, Gerri
AU - Khairy, Paul
AU - Proietti, Anna
AU - Dore, Annie
AU - Mercier, Lise Andrée
AU - Mongeon, François Pierre
AU - Marcotte, François
AU - Ibrahim, Reda
AU - Mondésert, Blandine
AU - Côté, Marie Claude
AU - Kovacs, Adrienne
AU - Oechslin, Erwin
N1 - Funding Information:
The authors would like to thank Dr. Sandra Distefano (Consultant in Public Health Medicine, Directorate for Health Information and Research) for providing national statistics on infective endocarditis. APPROACH-IS consortium: Luis Alday, H?ctor Maisuls, Betina Vega (C?rdoba, Argentina, Hospital de Ni?os); Samuel Menahem, Sarah Eaton, Ruth Larion, Qi Feng Wang (Melbourne, Australia, Monash Medical Center); Werner Budts, Kristien Van Deyk (Leuven, Belgium, University Hospitals of Leuven); Silke Apers, Eva Goossens, Jessica Rassart, Koen Luyckx, Philip Moons (Leuven, Belgium, University of Leuven); Gwen Rempel, Andrew Mackie, Ross Ballantyne, Kathryn Rankin, Colleen Norris, Dylan Taylor, Isabelle Vondermuhll, Jonathan Windram, Pamela Heggie, Gerri Lasiuk (Edmonton, Canada, University of Alberta); Paul Khairy, Anna Proietti, Annie Dore, Lise-Andr?e Mercier, Fran?ois-Pierre Mongeon, Fran?ois Marcotte, Reda Ibrahim, Blandine Mond?sert, Marie-Claude C?t? (Montreal, Canada, Montreal Heart Institute); Adrienne Kovacs, Erwin Oechslin, Mimi Bandyopadhyay (Toronto, Canada, University Health Network); Alexandra Soufi, Sylvie Di Filippo, Fran?ois Sassolas, Andr? Bozio (Lyon, France, Hospital Louis Pradel); Shanthi Chidambarathanu, Farida Farzana, Nitya Lakshmi (Chennai, India, Frontier Lifeline Hospital, Dr. K. M. Cherian Heart Foundation); Edward Callus, Emilia Quadri, Massimo Chessa, Giovanna Campioni, Alessandro Giamberti (Milan, Italy, IRCCS Policlinco San Donato Hospital); Junko Enomoto, Yoshiko Mizuno (Chiba, Japan, Chiba Cardiovascular Center); Maryanne Caruana, Victor Grech, Sheena Vella, Anabel Mifsud, Neville Borg, Daniel Chircop, Matthew Mercieca Balbi, Rachel Vella Critien, James Farrugia, Yanika Gatt, Darlene Muscat (Msida, Malta, Mater Dei Hospital); Katrine Eriksen, Mette-Elise Estensen (Oslo, Norway, Oslo University Hospital); Mikael Dellborg, Malin Berghammer (Gothenburg, Sweden, Sahlgrenska University Hospital); Eva Mattson, Anita Strandberg, Pia Karlstr?m-Hallberg (Stockholm, Sweden, Karolinska University Hospital); Bengt Johansson, Anna-Karin Kronhamn (Ume?, Sweden, University Hospital of Ume?); Markus Schwerzmann, Corina Thomet, Margrit Huber (Bern, Switzerland, University Hospital Bern); Jou-Kou Wang, Chun-Wei Lu, Hsiao-Ling Yang, Yu Chuan Hua (Taipei, Taiwan, National Taiwan University Hospital); Barbara Mulder, Maayke Sluman (Amsterdam, the Netherlands, Amsterdam Medical Center); Marco Post (Nieuwegein, the Netherlands, St. Antonius Hospital); Els Pieper (Groningen, the Netherlands, University Medical Center Groningen); Kathinka Peels (Eindhoven, the Netherlands, Catharina Hospital); Marc Waskowsky (Zwolle, the Netherlands, Isala Clinic); Gruschen Veldtman, Michelle Faust, Colin Lozier, Christy Reed, Jamie Hilfer (Cincinnati, USA, Cincinnati Children?s Hospital Medical Center); Curt Daniels, Jamie Jackson (Columbus, USA, Nationwide Children?s Hospital); Shelby Kutty, Carolyn Chamberlain (Omaha, USA, Children?s Hospital & Medical Center); Stephen Cook, Morgan Hindes (Pittsburgh, USA, Children?s Hospital of Pittsburgh of UPMC); Ari Cedars, Kamila White (Saint Louis, USA, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri); Anitra Rompfh, Susan Fernandes, Kirstie MacMillen (Palo Alto, USA, Stanford University). The APPROACH-IS project was supported by the Research Fund?KU Leuven (Leuven, Belgium) through grant OT/11/033; by the Swedish Heart?Lung Foundation (Sweden) through Grant No. 20130607; and by the University of Gothenburg Centre for Person-centred Care (Gothenburg, Sweden). In Malta, the work was supported financially by A.M. Mangion Ltd. (Luqa, Malta), Technoline Ltd. (Gzira, Malta) and Cherubino Ltd. (Gzira, Malta) which together covered the costs of printing and posting of the questionnaires. Collaborators of the APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD) are listed in "Acknowledgements".
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013–2015 during “Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study” (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale.
AB - Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013–2015 during “Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study” (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale.
KW - Congenital heart disease
KW - Health behaviour
KW - Lifestyle
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85016009007&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016009007&partnerID=8YFLogxK
U2 - 10.1007/s00246-017-1604-y
DO - 10.1007/s00246-017-1604-y
M3 - Article
C2 - 28341902
AN - SCOPUS:85016009007
VL - 38
SP - 965
EP - 973
JO - Pediatric Cardiology
JF - Pediatric Cardiology
SN - 0172-0643
IS - 5
ER -