Analysis of Cardiovascular Risk Factors in Adults with Congenital Heart Disease

Abstract

Background and ObjectivesThe objective of this study was to analyze cardiovascular risk factors in adults with congenital heart disease (ACHD).Subjects and MethodsThe subjects for this study comprised 135 patients, aged 18 years and above, who visited the ACHD clinic at the Samsung Medical Center and 135 adults with a structurally normal heart who were randomly selected from the Center for Health Promotion during the same period. For the analysis, the ACHD group was further divided into an ACHD group that underwent correction by cardiac surgery and a cyanotic group.ResultsThe mean (standard diviation) age (years) of patients in the surgically corrected group was 48.4 (10.9) years, while that of patients in the cyanotic group was 43.1 (9.0) years and that of patients in the control group was 47.1 (10.3) years (p=0.042). The adjusted odds ratios (ORs) for past smoking, hypertension, diabetes mellitus, hypercholesterolemia, obesity, and metabolic syndrome were significantly higher in the surgically corrected patients than in the controls. However, the ORs for all variables excluding past smoking were significantly lower in the cyanotic group compared with the control group. After adjustment for age, gender, smoking, alcohol use, and exercise, the ORs for metabolic syndrome were 0.46 (0.35-0.57, p<0.001) and 1.48 (1.14-1.92, p=0.003) in the cyanotic and surgically corrected groups, respectively.ConclusionCardiovascular risk factors need to be considered in surgically corrected ACHD patients as well as in adults with a structurally normal heart. A further study with a long-term follow-up is needed for developing guidelines for prevention.

Cardiovascular risk factors in adults with coarctation of the aorta

“…The proportion of overweight and obese patients in our study is consistent with published data on BMI in ACHD in Sweden . In contrast, our study showed a lower prevalence of smoking compared with several other studies on smoking behavior in patients with congenital heart disease . In our study, there was a slightly lower prevalence of diabetes mellitus than that previously reported …”

“…24 In contrast, our study showed a lower prevalence of smoking compared with several other studies on smoking behavior in patients with congenital heart disease. [36][37][38] In our study, there was a slightly lower prevalence of diabetes mellitus than that previously reported. 16 Several studies have reported a high burden of cardiovascular There is a growing body of evidence that patients with congenital heart disease have a higher prevalence of ischemic heart disease compared with controls.…”

Risk Estimates for Atherosclerotic Cardiovascular Disease in Adults With Congenital Heart Disease

“…Hyperlipidemia has been noted in surgically corrected ACHD patients but lower cholesterol is often seen in palliated or unrepaired CHD patients who remain cyanotic. 19,20 Almost 10% of patients in this series met criteria for metabolic syndrome 12,13 , and others have reported their prevalence of metabolic syndrome to be 1.5 times higher in ACHD patients than in health controls. 21 Based upon these findings, it appears prudent to consider at least guideline-based screening and management of ASCVD risk factors in the CHD population.…”

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

“…A Korean study showed a similarly higher rate of metabolic syndrome in the surgically corrected ACHD group of 37% versus 24% in control subjects. 290 Cyanotic CHD was protective against metabolic syndrome in this cohort.…”

“…308 A Korean study found low-density lipoprotein to be higher and high-density lipoprotein lower in patients with CHD than in a control group. 290 Low high-density lipoprotein and high triglycerides may be related to the same factors promoting metabolic syndrome in these patients. 289 Although data remain limited to single centers or administrative databases, the prevalence of dyslipidemia appears to be similar to that in the general population.…”