Methods: We used competing risks methodology to analyze death without transplantation, cardiac transplantation, and survival without transplantation. Parametric time-to-event modeling and bootstrapping were used to identify independent predictors.

Results: Data from 549 subjects (follow-up, 2.7 +/- 0.9 years) were analyzed. Mortality risk was characterized by early and constant phases; transplant was characterized by only a constant phase. Early phase

factors associated with death included lower socioeconomic status (P = .01), obstructed pulmonary Belnacasan supplier venous return (P < .001), smaller ascending aorta (P = .02), and anatomic subtype. Constant phase factors associated with death included genetic syndrome (P < .001) and lower gestational age (P < .001). The right ventricle-to-pulmonary artery

shunt demonstrated better survival in the 51% of subjects who were full term with aortic Selleck SU5402 atresia (P < .001). The modified Blalock-Taussig shunt was better among the 4% of subjects who were preterm with a patent aortic valve (P = .003). Lower pre-Norwood right ventricular fractional area change, pre-Norwood surgery, and anatomy other than hypoplastic left heart syndrome were independently associated with transplantation (all P < .03), but shunt type was not (P = .43).

Conclusions: Independent risk factors for intermediate-term mortality include lower socioeconomic status, anatomy, genetic syndrome, and lower gestational age. Term infants with aortic atresia benefited from a right ventricle-to-pulmonary artery shunt, and preterm infants with a patent aortic valve benefited from a modified Blalock-Taussig shunt. Right ventricular function and anatomy, but not shunt type, were associated with transplantation. (J Thorac Cardiovasc Surg 2012;144:152-9)”
“Background: New immigrants Selleck Buparlisib to North America exhibit lower rates of obesity and hypertension than their native-born counterparts Whether this is reflected

by a lower relative risk of acute myocardial infarction (AMI) is not known.

Objective: To determine the risk of AMI among new immigrants compared to long-term residents, and, among those who develop AMI, their short- and long-term mortality rate

Design: Population-based, matched, retrospective cohort study.

Setting: Entire province of Ontario, the most populated province in Canada, from 1 April 1995 to 31 March 2007.

Participants: A total of 965 829 new immigrants were matched to 3 272 393 long-term residents by year of birth, sex and geographic location.

Measurements: The main study outcome was hospitalization with a most responsible diagnosis of AMI Secondary study outcomes among those who sustained an AMI were in-hospital, 30-day and 1-year mortality.

Results: The mean age of the participants at study entry was 34 years.