Levene Jacqueline, Cambron Claire, McGrath Lidija, Garcia Ibett Colina, Broberg Craig, Ramsey Katrina, Khan Abigail
Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
Adult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.
Int J Cardiol Congenit Heart Dis. 2022 Nov 11;11:100424. doi: 10.1016/j.ijcchd.2022.100424. eCollection 2023 Mar.
Adults with congenital heart disease (CHD) may be at increased risk of acquired cardiovascular disease (CVD). Understanding the prevalence of CV risk factors (CVRF) in this population is an important step in developing strategies to mitigate long-term risk.
The Oregon All Payer All Claims database for the years 2010-2017 was queried for adults with CHD International Classification of Diseases (ICD) codes. The prevalence of CVRF was measured, and we then evaluated the association with patient characteristics.
There were 13,896 individuals with CHD. 72.8% (99% CI: 71.8-73.7) had at least one RF and 52.3% (99% CI: 51.2-53.4) had ≥2 RF. The prevalence of ≥1 RF increased with age (18-24: 39.6% (99% CI: 37.0-42.1) vs. 93.6% (99% CI: 92.6-94.6) in those 55-65). Hypertension (aOR 1.49 (99% CI: 1.36-1.63)), diabetes (aOR 1.24 (99% CI: 1.13-1.36)), sleep apnea (aOR 1.40 (99% CI 1.26-1.55)) and kidney disease (aOR 1.33 (99% CI:1.14-1.54)) were more prevalent in moderate-complex as opposed to simple CHD. When compared with a matched non-CHD population, there was higher prevalence of CVRF in ACHD (≥1 RF: 76.1 vs. 64.1%, OR 1.79 (99% CI: 1.69-1.89); ≥2 RF: 52.6 vs. 36.5%, OR 1.92 (99% CI: 1.83-2.03).
To our knowledge, this is the first comprehensive attempt to measure both traditional and non-traditional CVRF in US adults with CHD. We show that CVRF are common even in young adults. Given the additive effect of acquired CVD on CHD, addressing RF should be an important priority for in ACHD.
患有先天性心脏病（CHD）的成年人患后天性心血管疾病（CVD）的风险可能会增加。了解该人群中心血管危险因素（CVRF）的患病率是制定减轻长期风险策略的重要一步。
查询2010 - 2017年俄勒冈州全支付方全索赔数据库中患有CHD的成年人的国际疾病分类（ICD）代码。测量CVRF的患病率，然后评估其与患者特征的关联。
共有13896名患有CHD的个体。72.8%（99%置信区间：71.8 - 73.7）至少有一个危险因素，52.3%（99%置信区间：51.2 - 53.4）有≥2个危险因素。≥1个危险因素的患病率随年龄增加而升高（18 - 24岁：39.6%（99%置信区间：37.0 - 42.1），而55 - 65岁人群中为93.6%（99%置信区间：92.6 - 94.6））。与简单CHD相比，中度复杂CHD中高血压（调整后比值比[aOR] 1.49（99%置信区间：1.36 - 1.63））、糖尿病（aOR 1.24（99%置信区间：1.13 - 1.36））、睡眠呼吸暂停（aOR 1.40（99%置信区间1.26 - 1.55））和肾脏疾病（aOR 1.33（99%置信区间：1.14 - 1.54））更为普遍。与匹配的非CHD人群相比，先天性心脏病（ACHD）患者中CVRF的患病率更高（≥1个危险因素：76.1%对64.1%，比值比[OR] 1.79（99%置信区间：1.69 - 1.89）；≥2个危险因素：52.6%对36.5%，OR 1.92（99%置信区间：1.83 - 2.03））。
据我们所知，这是首次全面尝试测量美国患有CHD的成年人中的传统和非传统CVRF。我们表明，即使在年轻人中CVRF也很常见。鉴于后天性CVD对CHD的叠加效应，解决危险因素应是ACHD的重要优先事项。
