{"doi":"10.1016/j.jacadv.2025.102116","title":"Adults With Congenital Heart Disease Have an Increased Prevalence of Autoimmunity","abstract":"BACKGROUND: Adult congenital heart disease (ACHD) individuals have increased risk of noncardiac comorbidities including cancer and infections. Whether they are at increased risk of autoimmunity is unknown. OBJECTIVES: The purpose of this study was to understand the association of ACHD and risk for autoimmunity. METHODS: A case-control study was performed using All of Us, a nationwide biomedical database. In 2024, we queried autoimmune conditions and ACHD individuals ≥18 year of age with congenital heart disease (CHD) diagnoses determined using SNOMED, International Classification of Diseases (ICD)-9-CM, and ICD-100-CM classifications. ACHD individuals were matched 1:20 to controls for age, race, sex, smoking, and obesity. We examined subcategories of mild/moderate/severe CHD. RESULTS: Among 287,012 participants, 2941 ACHD (1.02%) individuals (mean age 62 years, 55.3% female) were identified. ACHD individuals had increased odds of autoimmunity (OR: 1.95; P < 0.05), both systemic (OR: 1.94; P < 0.05) and organ specific (OR: 1.54; P < 0.05) conditions. Sixty-nine percent had sufficient detail to be classified into mild/moderate/severe CHD; severe group was smaller and younger (n = 162, mean age = 47.6 years) compared to mild (n = 1169, mean age = 63.8) and moderate (n = 703, mean age = 61.8 years) groups. Mild and moderate CHD were associated with autoimmunity (OR: 1.93; P < 0.05 and OR: 1.56; P < 0.05, respectively). The entire severe CHD group did not show an increase in odds of autoimmunity (OR: 1.45; P = 0.168). When the groups were subdivided by age, severe ACHD individuals ≥60 years did show increased odds of autoimmunity (OR: 2.71; P < 0.05). CONCLUSIONS: ACHD individuals showed a nearly 2-fold increased odds of developing autoimmune conditions, both for systemic and organ-specific autoimmunity, which persisted among those with simple/moderate CHD. In an age-related analysis, the severe CHD group ≥60 years has a similar risk.","journal":"JACC Advances","year":2025,"id":574342,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6063,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":408961,"name":"Insoo Kang","orcid":"0000-0001-7483-1171","position":1,"is_corresponding":false},{"id":381677,"name":"Keith A. Choate","orcid":"0000-0003-1010-6354","position":2,"is_corresponding":false},{"id":966917,"name":"Robert W. Elder","orcid":"0000-0002-4956-8604","position":3,"is_corresponding":false},{"id":79435,"name":"William J. Liu","orcid":null,"position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T02:57:40.686992Z","pmid":"40913926","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}