Dyslipidemia Among Adults With Congenital Heart Disease.

Autor:	Wu FM; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.; Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Mendelson ME; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA., Huang Y; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA., Palfrey H; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA., Valente AM; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.; Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Drucker NA; Division of Pediatric Cardiology, Department of Pediatrics, University of Vermont, Burlington, Vermont, USA., Moran AM; Department of Pediatrics, Maine Medical Center, Portland, Maine, USA., Yeager SB; Division of Pediatric Cardiology, Department of Pediatrics, University of Vermont, Burlington, Vermont, USA., de Ferranti SD; Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	JACC. Advances [JACC Adv] 2022 Aug 31; Vol. 1 (4), pp. 100081. Date of Electronic Publication: 2022 Aug 31 (Print Publication: 2022).
DOI:	10.1016/j.jacadv.2022.100081
Abstrakt:	Background: Atherosclerotic disease is an important cause of morbidity among adults with congenital heart disease (CHD). Prevalence of dyslipidemia in this group is poorly described. Objectives: This study aimed to describe the prevalence of dyslipidemia among adults with CHD. Methods: A prospective, outpatient screening study was conducted among adults aged ≥18 years at 4 New England ambulatory congenital cardiology centers. Participants were surveyed regarding cardiovascular risk factors. Nonfasting fingerstick samples were obtained for analysis using a point-of-care lipid analyzer. Results: Lipid screening was completed on 186 participants (median age 30 [range 18-71] years, 50% female). Eighteen (10%) had simple CHD anatomy, and 63 (34%) had complex anatomy. Only 15% of 169 respondents reported history of high cholesterol. Eighty-five (46%) participants met National Cholesterol Education Program definition of dyslipidemia with 60 (32%), 62 (34%), and 37 (20%) having low high-density lipoprotein cholesterol (HDL-C <40 mg/dL), high non-HDL-C (≥130 mg/dL), and high total cholesterol (TC ≥200 mg/dL), respectively. TC was higher among participants with simple CHD than among those with moderate and complex lesions (mean 178.4 ± 48.7 vs 170.1 ± 35.0 vs 157.6 ± 34.5 mg/dL; P  = 0.03). HDL-C was lower among participants with complex CHD than among those with simple and moderate lesions (mean 44.1 ± 13.5 vs 46.9 ± 12.5 vs 49.8 ± 15.3 mg/dL; P  = 0.05). Conclusions: Dyslipidemia is highly prevalent among our cohort of adults with CHD, despite <15% reporting a prior diagnosis. Low HDL-C was more common in complex CHD, and high TC was more common in simple or moderate CHD. Lipid screening should be part of preventive health maintenance for all adults with CHD. Competing Interests: This study was supported in part by the Boston Adult Congenital Heart Disease Program Dunlevie Fund and by the New England Congenital Cardiology Research Foundation. Dr. Mendelson became an employee of Novartis after completion of study data collection. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.PERSPECTIVESCOMPETENCY IN MEDICAL KNOWLEDGE: Dyslipidemia was present in nearly one-half of the ACHD patients screened despite <15% of the cohort having a prior diagnosis of such. The pattern of lipid abnormalities differed, with low HDL-C being the predominant pattern among patients with complex CHD and high non–HDL-C being the predominant pattern among patients with simple and moderate CHD. TRANSLATIONAL OUTLOOK: These data strongly support the recommendation for regular screening for cardiovascular risk factors, particularly dyslipidemia, as part of routine ACHD care. (© 2022 The Authors.)
Databáze:	MEDLINE
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