ArticleJACC. Advances2026
Life-Course Noncardiac Comorbidity Burden and Mortality in Lower-Complexity Congenital Heart Disease.
Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundLower-complexity congenital heart disease (CHD) is generally perceived as a low-risk condition. However, its long-term systemic comorbidity burden and impact on survival remain poorly defined, despite increasing recognition of lifelong care needs.
objectivesThe authors aimed to determine whether lower-complexity CHD is a life-course condition characterized by high noncardiac comorbidity burden and mortality among adults.
methodsThis population-based prospective cohort study identified 3,316 adults with lower-complexity CHD and 492,232 individuals without CHD from the UK Biobank. The primary outcome was the first occurrence of 9 system-specific noncardiac comorbidities, with relative rates estimated by multivariable Cox regression models and lifetime risk from age 40 to 90 assessed using life-table methods. The secondary outcome was all-cause mortality among individuals with lower-complexity CHD, assessed according to baseline and incident comorbidity status using time-varying Cox regression models. The median follow-up was approximately 13 years.
resultsCompared to individuals without CHD, adults with lower-complexity CHD had significantly elevated relative rates of noncardiac comorbidities across 9 organ systems, particularly for blood, endocrine, and pulmonary diseases. Comorbidity incidence diverged from midlife and accelerated with age. Absolute lifetime risks ranged from 17.1% (skin disease) to 45.8% (digestive disease), with the largest excess risks observed in endocrine (18.6%), digestive (15.7%), and pulmonary (12.5%) systems. Among individuals with CHD, incident noncardiac comorbidities were independently associated with increased subsequent all-cause mortality, with pulmonary disease conferring the strongest relative rate.
conclusionsLower-complexity CHD is associated with higher lifetime noncardiac comorbidity burden and increased subsequent mortality. These findings support a shift toward integrated, life-course clinical management.
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