A Multicenter Cross-Sectional Study Of Dyslipidemia Among Adults In New England With Congenital Heart Disease

Background: Improved survival of individuals living with congenital heart disease (CongHD) has highlighted the importance of acquired atherosclerosis. Hypertension and diabetes are known to affect those with CongHD, compared to the general population. However, the prevalence of dyslipidemia among adults with CongHD is not well described. Objective: To describe the prevalence of dyslipidemia according to 2018 Multisociety Guideline on the Management of Blood Cholesterol and the frequency of lipid screening among adults with CongHD. Methods: We performed a prospective, cross-sectional study of individuals ≥18 years of age seen at four ambulatory congenital cardiology centers within the New England Congenital Cardiology Association regional referral network. Consenting subjects were administered a survey regarding prevalence of cardiovascular risk factors and previous screening. A non-fasting fingerprick sample of capillary blood was obtained from each subject for immediate analysis using a point-of-care lipid analyzer. Results: There were 186 subjects recruited with one subject excluded from analysis due to self-reported fever. Of the remaining 185 subjects, 93 (50.3%) were male. The median age was 30 years (range 18-71). CHD anatomy was classified as simple for 21 (11.4%) subjects, moderate for 101 (54.6%) subjects, and complex for 63 (34.1%) subjects. Of those who responded, 67.9% recalled having their cholesterol levels checked previously. Only 14.8% reported a history of high cholesterol or triglycerides. However, 85 (45.9%) subjects met NCEP definition of dyslipidemia, with 60 (32.4%) having HDL <40 mg/dL and 37 (20.0%) having TC ≥200 mg/dL. TC was significantly higher in the simple CHD group than in the moderate and complex groups (178.4 vs. 170.1 vs. 157.6, p=0.03). Conversely, HDL tended to be lower in complex CongHD compared to simple and moderate CHD (44.1 vs. 46.9 vs. 49.8, p=0.05), although this did not reach statistical significance. Conclusion: Dyslipidemia is highly prevalent among our cohort of adults with CongHD despite less than 15% reporting a prior diagnosis of high cholesterol. Low HDL, was most common, and predominated in those with complex CHD, while high TC more often affected individuals with simple and moderate CHD.