Subclinical atherosclerosis in patients with cyanotic congenital heart disease

Julie Bjerre Tarp; Mathias Holm Sorgaard; Christina Christoffersen; Annette Schophuus Jensen; Henrik Sillesen; David Celermajer; Peter Eriksson; Mette-Elise Estensen; Edit Nagy; Niels-Henrik Holstein-Rathlou; Thomas Engstrom; Lars Sondergaard

doi:10.1016/j.ijcard.2018.08.104

Subclinical atherosclerosis in patients with cyanotic congenital heart disease

Julie Bjerre Tarp, Mathias Holm Sorgaard, Christina Christoffersen, Annette Schophuus Jensen, Henrik Sillesen, David Celermajer, Peter Eriksson, Mette-Elise Estensen, Edit Nagy, Niels-Henrik Holstein-Rathlou, Thomas Engstrom, Lars Sondergaard

9 Citationer (Scopus)

Abstract

Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery calcification (CAC) score. Subclinical atherosclerosis was defined by CAC-score > 0. Carotid artery atherosclerosis was evaluated using ultrasound by measuring carotid plaque thickness (cPT-max) and carotid intima media thickness (CIMT). Lipid status was evaluated as an important atherosclerotic risk factor. Results: Seventy-four patients with CCHD (57% women, median age 49.5 years) and 74 matched controls (57% women, median age 50.0 years) were included. There were no differences between the groups in: CAC-score > 0 (21% vs. 19%, respectively; p = 0.8), carotid plaques (19% vs. 9%, respectively; p = 0.1), cPT-max (2.3 mm vs. 23 mm, respectively; p = 0.1) or CIMT (0.61 mm vs. 0.61 mm, respectively; p = 0.98). And further no significant differences in lipoprotein concentrations measured by ultracentrifugation. Conclusion: Young adults with CCHD have similar cardiovascular risk factor profiles and measures of subclinical atherosclerosis, compared with controls. Given their increasing life expectancies, athero-preventive strategies should be an important part of their clinical management. (C) 2018 Elsevier B.V. All rights reserved.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiology
Vol/bind	277
Sider (fra-til)	97-103
ISSN	0167-5273
DOI	https://doi.org/10.1016/j.ijcard.2018.08.104
Status	Udgivet - 15 feb. 2019

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10.1016/j.ijcard.2018.08.104

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Tarp, J. B., Sorgaard, M. H., Christoffersen, C., Jensen, A. S., Sillesen, H., Celermajer, D., Eriksson, P., Estensen, M-E., Nagy, E., Holstein-Rathlou, N-H., Engstrom, T., & Sondergaard, L. (2019). Subclinical atherosclerosis in patients with cyanotic congenital heart disease. International Journal of Cardiology, 277, 97-103. https://doi.org/10.1016/j.ijcard.2018.08.104

@article{305bca25e87e41f782e127b79b16825c,

title = "Subclinical atherosclerosis in patients with cyanotic congenital heart disease",

abstract = "Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery calcification (CAC) score. Subclinical atherosclerosis was defined by CAC-score > 0. Carotid artery atherosclerosis was evaluated using ultrasound by measuring carotid plaque thickness (cPT-max) and carotid intima media thickness (CIMT). Lipid status was evaluated as an important atherosclerotic risk factor. Results: Seventy-four patients with CCHD (57% women, median age 49.5 years) and 74 matched controls (57% women, median age 50.0 years) were included. There were no differences between the groups in: CAC-score > 0 (21% vs. 19%, respectively; p = 0.8), carotid plaques (19% vs. 9%, respectively; p = 0.1), cPT-max (2.3 mm vs. 2.8 mm, respectively; p = 0.1) or CIMT (0.61 mm vs. 0.61 mm, respectively; p = 0.98). And further no significant differences in lipoprotein concentrations measured by ultracentrifugation. Conclusion: Young adults with CCHD have similar cardiovascular risk factor profiles and measures of subclinical atherosclerosis, compared with controls. Given their increasing life expectancies, athero-preventive strategies should be an important part of their clinical management.",

keywords = "Cyanotic congenital heart disease, Coronary artery atherosclerosis, Carotid artery atherosclerosis, Hyperlipidemia, Coronary artery calcification, Cardiovascular disease",

author = "Tarp, {Julie Bjerre} and Sorgaard, {Mathias Holm} and Christina Christoffersen and Jensen, {Annette Schophuus} and Henrik Sillesen and David Celermajer and Peter Eriksson and Mette-Elise Estensen and Edit Nagy and Niels-Henrik Holstein-Rathlou and Thomas Engstrom and Lars Sondergaard",

year = "2019",

month = feb,

day = "15",

doi = "10.1016/j.ijcard.2018.08.104",

language = "English",

volume = "277",

pages = "97--103",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Subclinical atherosclerosis in patients with cyanotic congenital heart disease

AU - Tarp, Julie Bjerre

AU - Sorgaard, Mathias Holm

AU - Christoffersen, Christina

AU - Jensen, Annette Schophuus

AU - Sillesen, Henrik

AU - Celermajer, David

AU - Eriksson, Peter

AU - Estensen, Mette-Elise

AU - Nagy, Edit

AU - Holstein-Rathlou, Niels-Henrik

AU - Engstrom, Thomas

AU - Sondergaard, Lars

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery calcification (CAC) score. Subclinical atherosclerosis was defined by CAC-score > 0. Carotid artery atherosclerosis was evaluated using ultrasound by measuring carotid plaque thickness (cPT-max) and carotid intima media thickness (CIMT). Lipid status was evaluated as an important atherosclerotic risk factor. Results: Seventy-four patients with CCHD (57% women, median age 49.5 years) and 74 matched controls (57% women, median age 50.0 years) were included. There were no differences between the groups in: CAC-score > 0 (21% vs. 19%, respectively; p = 0.8), carotid plaques (19% vs. 9%, respectively; p = 0.1), cPT-max (2.3 mm vs. 2.8 mm, respectively; p = 0.1) or CIMT (0.61 mm vs. 0.61 mm, respectively; p = 0.98). And further no significant differences in lipoprotein concentrations measured by ultracentrifugation. Conclusion: Young adults with CCHD have similar cardiovascular risk factor profiles and measures of subclinical atherosclerosis, compared with controls. Given their increasing life expectancies, athero-preventive strategies should be an important part of their clinical management.

AB - Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery calcification (CAC) score. Subclinical atherosclerosis was defined by CAC-score > 0. Carotid artery atherosclerosis was evaluated using ultrasound by measuring carotid plaque thickness (cPT-max) and carotid intima media thickness (CIMT). Lipid status was evaluated as an important atherosclerotic risk factor. Results: Seventy-four patients with CCHD (57% women, median age 49.5 years) and 74 matched controls (57% women, median age 50.0 years) were included. There were no differences between the groups in: CAC-score > 0 (21% vs. 19%, respectively; p = 0.8), carotid plaques (19% vs. 9%, respectively; p = 0.1), cPT-max (2.3 mm vs. 2.8 mm, respectively; p = 0.1) or CIMT (0.61 mm vs. 0.61 mm, respectively; p = 0.98). And further no significant differences in lipoprotein concentrations measured by ultracentrifugation. Conclusion: Young adults with CCHD have similar cardiovascular risk factor profiles and measures of subclinical atherosclerosis, compared with controls. Given their increasing life expectancies, athero-preventive strategies should be an important part of their clinical management.

KW - Cyanotic congenital heart disease

KW - Coronary artery atherosclerosis

KW - Carotid artery atherosclerosis

KW - Hyperlipidemia

KW - Coronary artery calcification

KW - Cardiovascular disease

U2 - 10.1016/j.ijcard.2018.08.104

DO - 10.1016/j.ijcard.2018.08.104

M3 - Journal article

C2 - 30228018

SN - 0167-5273

VL - 277

SP - 97

EP - 103

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Subclinical atherosclerosis in patients with cyanotic congenital heart disease

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