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Subclinical atherosclerosis in patients with cyanotic congenital heart disease

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@article{1e6fdd757d9342ac842c482d8ae5dfc3,
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 = "Adult, Aged, Carotid Artery Diseases/diagnostic imaging, Coronary Artery Disease/diagnostic imaging, Cyanosis/diagnostic imaging, Female, Heart Defects, Congenital/diagnostic imaging, Humans, Male, Middle Aged, Prospective Studies, Young Adult",
author = "Tarp, {Julie Bjerre} and S{\o}rgaard, {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 Engstr{\o}m and Lars S{\o}ndergaard",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2019",
month = "2",
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",

}

RIS

TY - JOUR

T1 - Subclinical atherosclerosis in patients with cyanotic congenital heart disease

AU - Tarp, Julie Bjerre

AU - Sørgaard, 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 - Engstrøm, Thomas

AU - Søndergaard, Lars

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

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 - Adult

KW - Aged

KW - Carotid Artery Diseases/diagnostic imaging

KW - Coronary Artery Disease/diagnostic imaging

KW - Cyanosis/diagnostic imaging

KW - Female

KW - Heart Defects, Congenital/diagnostic imaging

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Young Adult

U2 - 10.1016/j.ijcard.2018.08.104

DO - 10.1016/j.ijcard.2018.08.104

M3 - Journal article

VL - 277

SP - 97

EP - 103

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -

ID: 58286790