Clinical Characteristics in Adult Congenital Heart Disease Patients With Acute Stroke　- A Retrospective Analysis.

Background: The number of adult congenital heart disease (ACHD) patients is rising due to advancements in surgery and medical treatment for congenital heart disease (CHD) during childhood. However, acute treatment and stroke prevention measures in ACHD patients have been insufficiently assessed. To address this insufficiency, we conducted a retrospective single-center investigation of the clinical characteristics of ACHD patients who experienced stroke. Methods and Results: We studied adult patients with acute stroke hospitalized within 7 days of onset between January 2011 and March 2017. Among 4,837 adults with stroke, 22 (0.5%) had CHD, including 19 with ischemic stroke and 3 with intracerebral hemorrhage. Compared with the non-CHD group, the ACHD group was younger (median age 56 vs. 75 years; P<0.01), had a higher incidence of large vessel occlusion (LVO; 53 vs. 24%; P=0.01), and exhibited more favorable functional outcomes at discharge (median modified Rankin scale 2 vs. 3; P=0.03). Atrial septal defect (ASD) was the most common underlying CHD, accounting for 55% of cases. Conclusions: ACHD patients with acute stroke were significantly younger and more frequently developed LVO compared with the general stroke population, with ASD being the most common type of CHD. Despite their favorable short-term prognosis, these characteristics must be considered to implement effective acute treatment and prevention strategies.