De Rosa Salvatore, Sabatino Jolanda, Di Salvo Giovanni, Torella Daniele, Di Mario Carlo
Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
Division of Paediatric Cardiology, Department of Women's and Children's Health, University Hospital Padua, Padua, Italy.
Int J Cardiol Congenit Heart Dis. 2023 Jun 29;13:100466. doi: 10.1016/j.ijcchd.2023.100466. eCollection 2023 Sep.
The increasing population of adult patients with congenital heart disease (ACHD) is at risk of developing coronary artery disease (CAD) and other atherosclerotic cardiovascular diseases due to exposure to cardiovascular risk factors. The impact of this exposure is growing larger as life expectancy of these subjects increases with the progressive improvement in management of congenital heart disease. Studies have shown that ACHD patients have a higher risk for CAD than their non-ACHD matches, highlighting the need for awareness and prevention efforts among congenital heart disease specialists and non-ACHD cardiologists. At the same time, ACHD patients with CAD often present specific characteristics all practicing cardiologists should be aware of. While further research is needed to fully understand the mechanisms underlying the higher CAD risk in this population, this article summarizes key evidence on CAD in ACHD and emphasizes on one hand the importance of early screening and management of known cardiovascular risk factors in ACHD patients, particularly those who are younger, female, or have more complex/severe CHD. On the other hand, it calls for a broader knowledge of ACHD risk for CAD and its peculiarities among all cardiologists.
由于暴露于心血管危险因素，先天性心脏病成年患者（ACHD）数量不断增加，面临着患冠状动脉疾病（CAD）和其他动脉粥样硬化性心血管疾病的风险。随着先天性心脏病管理的逐步改善，这些患者的预期寿命增加，这种暴露的影响也越来越大。研究表明，ACHD患者患CAD的风险高于非ACHD患者，这凸显了先天性心脏病专家和非ACHD心脏病专家提高认识并开展预防工作的必要性。同时，患有CAD的ACHD患者往往具有一些所有执业心脏病专家都应了解的特定特征。虽然需要进一步研究以充分了解该人群CAD风险较高的潜在机制，但本文总结了ACHD患者CAD的关键证据，并一方面强调了对ACHD患者，特别是那些较年轻、女性或患有更复杂/严重先天性心脏病的患者，早期筛查和管理已知心血管危险因素的重要性。另一方面，它呼吁所有心脏病专家更广泛地了解ACHD患者患CAD的风险及其特殊性。
