Coronary Disease and Modifying Cardiovascular Risk in Adult Congenital Heart Disease Patients: Should General Guidelines Apply?
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There are >1.4 million adult congenital heart disease (CHD; ACHD) patients living in the United States. Coronary artery disease (CAD) is at least as prevalent in ACHD patients as in the general population and has become a leading cause of their mortality. In the majority of cases, CAD in the ACHD population is driven by the presence of traditional cardiovascular disease (CVD) risk factors. 80% of ACHD patients have at least one CVD risk factor. Hypertension (HTN), obesity and physical inactivity are frequently seen in both pediatric and adult patients with CHD. Many ACHD patients demonstrate abnormal glucose metabolism and are at an increased risk for developing diabetes. Current guidelines for CVD risk assessment and prevention do not specifically mention patients with CHD but are likely applicable to most of these patients. Specific CHD populations have "high-risk" lesions that are associated with an increased risk of CVD complications and may warrant intensified screening and treatment. These include patients with a history of coarctation of the aorta or with prior coronary artery ostial manipulation (patients with a history of d-transposition of the great arteries or anomalous aortic origin of a coronary artery). The physiology of single ventricle patients is also poorly suited for the effects of superimposed CVD; these patients may benefit from intensified treatment of CVD risk factors, particularly HTN and obesity.
Heart Defects, Congenital
Preventive Health Services
Practice Guidelines as Topic
Published Version (Please cite this version)10.1016/j.pcad.2018.07.018
Publication InfoAwerbach, Jordan D; Krasuski, Richard A; & Camitta, Michael GW (2018). Coronary Disease and Modifying Cardiovascular Risk in Adult Congenital Heart Disease Patients: Should General Guidelines Apply?. Progress in cardiovascular diseases, 61(3-4). pp. 300-307. 10.1016/j.pcad.2018.07.018. Retrieved from https://hdl.handle.net/10161/17942.
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Tom Anstrom Fellow in Adult Congenital Heart Disease
Associate Professor of Pediatrics
EchocardiographyFetal cardiologyPediatric congenital and acquired heart diseaseAdult congenital heart disease Single ventricle palliation approaches, long-term medical therapies and outcome improvement. Pericardial effusions after bone marrow transplantation. Risk factors for development of pulmonary hypertension in the adult congenital cardiac populationTreatment of pulmonary hypertension in adult congenital c
Professor of Medicine
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