Wu Fred M, Mendelson Michael E, Huang Yisong, Palfrey Hannah, Valente Anne Marie, Drucker Nancy A, Moran Adrian M, Yeager Scott B, de Ferranti Sarah D
Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.
Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
JACC Adv. 2022 Aug 31;1(4):100081. doi: 10.1016/j.jacadv.2022.100081. eCollection 2022 Oct.
Atherosclerotic disease is an important cause of morbidity among adults with congenital heart disease (CHD). Prevalence of dyslipidemia in this group is poorly described.
This study aimed to describe the prevalence of dyslipidemia among adults with CHD.
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.
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; = 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; = 0.05).
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.
动脉粥样硬化性疾病是先天性心脏病（CHD）成人患者发病的重要原因。该群体中血脂异常的患病率描述甚少。
本研究旨在描述CHD成人患者中血脂异常的患病率。
在新英格兰地区4个门诊先天性心脏病中心，对年龄≥18岁的成人进行了一项前瞻性门诊筛查研究。对参与者进行心血管危险因素调查。使用即时检测血脂分析仪采集非空腹指尖血样本进行分析。
186名参与者完成了血脂筛查（中位年龄30岁[范围18 - 71岁]，50%为女性）。18名（10%）患者为简单CHD解剖结构，63名（34%）患者为复杂解剖结构。169名受访者中只有15%报告有高胆固醇病史。85名（46%）参与者符合国家胆固醇教育计划血脂异常的定义，其中60名（32%）、62名（34%）和37名（20%）分别有低高密度脂蛋白胆固醇（HDL-C<40mg/dL）、高非HDL-C（≥130mg/dL）和高总胆固醇（TC≥200mg/dL）。简单CHD患者的TC高于中度和复杂病变患者（均值178.4±48.7 vs 170.1±35.0 vs 157.6±34.5mg/dL；P = 0.03）。复杂CHD患者的HDL-C低于简单和中度病变患者（均值44.1±13.5 vs 46.9±12.5 vs 49.8±15.3mg/dL；P = 0.05）。
在我们的CHD成人队列中，血脂异常非常普遍，尽管<15%报告曾有诊断。低HDL-C在复杂CHD中更常见，高TC在简单或中度CHD中更常见。血脂筛查应成为所有CHD成人预防性健康维护的一部分。
