Papazoglou Andreas S, Kyriakoulis Konstantinos G, Barmpagiannos Konstantinos, Moysidis Dimitrios V, Kartas Anastasios, Chatzi Maria, Baroutidou Amalia, Kamperidis Vasileios, Ziakas Antonios, Dimopoulos Konstantinos, Giannakoulas George
Athens Naval Hospital, Athens, Greece.
National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
JACC Adv. 2024 Oct 19;3(11):101359. doi: 10.1016/j.jacadv.2024.101359. eCollection 2024 Nov.
The risk of atherosclerotic cardiovascular disease (ASCVD) in adults with congenital heart disease (ACHD) is comparable to that of the general population and is driven by traditional ASCVD risk factors.
The aim of the study was to estimate the prevalence of traditional ASCVD risk factors (hypertension, dyslipidemia, diabetes mellitus [DM], obesity, smoking, and physical inactivity) in ACHD and compare it with the general population.
A systematic literature search was conducted up to May 15, 2024, to identify studies (with or without control group) reporting the prevalence of ASCVD risk factors in ACHD. Meta-analyses were conducted to synthesize the prevalence of risk factors and compare it with that of the general population, where applicable.
We identified 62 studies (30 controlled) encompassing 110,469 ACHD (mean age 39 years; 52% males, 88% with simple/moderate congenital heart disease complexity). Of these, 54% (45%-63%) reported lack of regular exercise, 33% (26%-40%) had hypertension, 18% (14%-22%) were obese, 17% (11%-25%) had dyslipidemia, 12% (9%-14%) were current smokers, and 7% (5%-9%) had DM. The prevalence of ASCVD risk factors was similar in ACHD and controls, with the exception of DM (higher prevalence in ACHD) and smoking (lower prevalence in ACHD). Significant heterogeneity was observed among the included studies, partially explained by differences in age, congenital heart disease complexity, and the presence of cyanosis.
Except for DM and smoking, the prevalence of traditional ASCVD risk factors is similar in ACHD compared to the general population. Further research is needed to determine whether interventions applied in the general population are also effective in ACHD.
患有先天性心脏病（ACHD）的成年人发生动脉粥样硬化性心血管疾病（ASCVD）的风险与普通人群相当，且由传统的ASCVD风险因素驱动。
本研究旨在评估ACHD患者中传统ASCVD风险因素（高血压、血脂异常、糖尿病[DM]、肥胖、吸烟和身体活动不足）的患病率，并与普通人群进行比较。
截至2024年5月15日进行了系统的文献检索，以确定报告ACHD患者中ASCVD风险因素患病率的研究（有或无对照组）。进行荟萃分析以综合风险因素的患病率，并在适用时与普通人群进行比较。
我们纳入了62项研究（30项有对照），涉及110469例ACHD患者（平均年龄39岁；52%为男性，88%患有简单/中度先天性心脏病复杂性）。其中，54%（45%-63%）报告缺乏规律运动，33%（26%-40%）患有高血压，18%（14%-22%）肥胖，17%（11%-25%）血脂异常，12%（9%-14%）为当前吸烟者，7%（5%-9%）患有DM。除DM（ACHD患者中患病率较高）和吸烟（ACHD患者中患病率较低）外，ACHD患者和对照组中ASCVD风险因素的患病率相似。纳入研究之间观察到显著的异质性，部分原因是年龄、先天性心脏病复杂性和青紫的存在存在差异。
除DM和吸烟外，ACHD患者中传统ASCVD风险因素的患病率与普通人群相似。需要进一步研究以确定应用于普通人群的干预措施在ACHD患者中是否也有效。
