PB0625 - Types of Thromboembolism and Antithrombotic Strategies in Pediatric Congenital Heart Disease

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Amy Kiskaddon, PharmD, MBA

Assistant Professor of Pediatrics
Johns Hopkins University, Florida, United States

Co-Author(s)

AS

Arabela Stock

Pediatric Cardiac Intensivist
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, United States
Vera Ignjatovic, PhD, MBA

Professor of Pediatrics
Johns Hopkins All Children's Institute for Clinical and Translational Research; Department of Pediatrics, School of Medicine, Johns Hopkins University, United States
St Petersburg, Florida, United States
ND

NHUE DO

Surgical Director, Pediatric Heart Transplant and Ventricular Assist Device Program
Vanderbilt University
Nashville, Tennessee, United States
Neil Goldenberg, MD,PhD

Departments of Pediatrics and Medicine
Johns Hopkins University School of Medicine, Baltimore, MD; Clinical and Data Coordinating Center for Pediatric Multicenter Studies, Johns Hopkins All Children’s Institute for Clinical and Translational Research, St. Petersburg, FL
Saint Petersburg, Florida, United States

Background: Pediatric patients with congenital heart disease (CHD) are known to be at risk for thromboembolic events (TE). However, limited data describe the types of lesions and types/locations of TE that occur in these patients. Understanding the types of CHD in which TE is occurring are essential in developing prediction models and antithrombotic therapy selection.

Aims: To evaluate the type of CHD, TE, and antithrombotic therapies in pediatric patients with CHD and TE.

Methods: We queried the TriNetX Research database for patients under the age of 18 years who had a diagnosis of congenital heart disease and thromboembolism. The primary analysis evaluated the type of congenital heart disease in patients who developed TE. We performed additional analysis assessing types and locations of TE, as well as antithrombotic prescribing patterns in patients with CHD and TE.

Results: Of 53,293 pediatric patients with CHD, 7197 (13.5%) developed a TE, with a mean (SD) age range of 4.1 ± 5.83 years at the time of the index event. Most patients (n=3986, 56%) were male, not Hispanic/Latino (n=5176, 72%), and white (n=4094, 57%). Malformations of the cardiac septa (n=3576, 50%) and great arteries (n=2840, 40%) were the most common types of CHD in pediatric patients who developed a TE. The most common type of TE in pediatric patients with a CHD diagnosis was venous (2262, 32%). Heparin was utilized most frequently (4189, 58 %) as an antithrombotic therapy, and antiplatelet therapies were used in (2065, 31%) of patients.

Conclusion(s): Children with CHD who develop TE have varying types of CHD and are associated with heterogenous antithrombotic therapy prescribing practices. Future studies evaluating the rate of recurrent TE and types of antithrombotic therapies prescribed will better identify optimal management strategies in these patients.