Cardiovascular risk factors and arterial thrombotic events in congenital heart disease patients

Abstract

Introduction:As congenital patients get older, it can be hypothesised that cardiovascular risk factors increase.Methods: Retrospective study of congenital heart disease (CHD) patients attended between January 2008 and September 2018. Cardiovascular risk factors, myocardial infarction, stroke, peripheral vascular disease, and analytical data such as serum glucose and lipid profile were determined.Results: Eight hundred and eighteen CHD patients and 1955 control patients matched for age and sex were studied. CHD patients were distributed in simple (462 patients), moderate (228 patients) and great (128 patients) complexity. Median age in CHD patients was 33 (25-41) years old and 56% were male. CHD patients were significantly more hypertensive and diabetic but less dyslipidemic and smokers than patients in the control group. Twenty-seven (3.3%) CHD patients had an arterial thrombotic event: 3 coronary, 22 neurological and 2 peripheral vascular disease. No significant differences were seen in the incidence of myocardial infarction between the control and the CHD groups. However CHD patients had a significant higher incidence of arterial thrombotic events (coronary, neurological and peripheral vascular events) at the expense of strokes and transient ischaemic attacks (22 vs 2 events in CHD and control patients, respectively). Also, no significant differences were seen in age, sex, BMI, arterial hypertension, diabetes mellitus, dyslipidemia, smoking habit, serum glucose, total and LDL cholesterol, statin treatment, myocardial infarction and arterial thrombotic events according to CHD complexity. Being older and having arterial hypertension, diabetes mellitus, dyslipidemia and smoking habit were more frequent among CHD patients with arterial thrombosis. Conclusions:Congenital heart diseases are more hypertensive and diabetic but less dyslipemic and smokers than patients in the control group. CHD patients have a higher incidence of neurological events but not of myocardial infarction in relation to the control population.

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“…Consistent with published classification schema, cardiac defects were categorized as being of simple, moderate or great complexity [19]. Arterial hypertension and diabetes mellitus were diagnosed according to the European Society of Cardiology guidelines [20][21][22] in patients with CHD and controls. Patients were considered as dyslipidaemic if they were receiving statin therapy, and as smokers if they were current smokers.…”

Differential serum lipid distribution in IPAH and CHD-PAH patients

“…In addition, although not reported a relation with poor prognosis, serum total cholesterol (CHOL) is also reduced in PAH [20][21][22]. In this context, the reduction of cholesterol molecules such as HDL-C, LDL-C and CHOL has been previously demonstrated in CHD patients [23][24][25][26], those factors have not been investigated in CHD-PAH.…”

Gamma‐glutamyl transferase and cardiovascular events in patients with congenital heart disease

“…Cardiovascular imaging established the diagnosis of CHD, and patients were classified into diagnostic groups, according to their anatomical complexity, in simple, moderate, or great cardiac defects 8 . Cardiovascular risk factors (arterial hypertension, diabetes mellitus, dyslipidemia and smoking habit) were categorized as previously reported 9 . Body mass index (BMI) was calculated as weight in kilograms divided by the square of height in metres.…”

“…8 Cardiovascular risk factors (arterial hypertension, diabetes mellitus, dyslipidemia and smoking habit) were categorized as previously reported. 9 Body mass index (BMI) was calculated as weight in kilograms divided by the square of height in metres. Having atrial fibrillation or flutter and being a carrier of a mechanical valve prosthesis was determined by electrocardiogram or medical history.…”