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Subclinical atherosclerosis in children and adolescents with congenital heart disease

Published online by Cambridge University Press:  11 December 2020

Silvia M. Cardoso Open the ORCID record for Silvia M. Cardoso [Opens in a new window] ,
Michele Honicky ,
Yara M. F. Moreno ,
Luiz R. A. de Lima ,
Matheus A. Pacheco  and
Isabela de C. Back
Silvia M. Cardoso
Affiliation:
Pediatric Cardiologist at Polydoro Ernani São Tiago University Hospital, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil Postgraduate Program in Public Health, Federal University of Santa Catarina, Florianopolis, Brazil
Michele Honicky
Affiliation:
Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil
Yara M. F. Moreno
Affiliation:
Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil
Luiz R. A. de Lima
Affiliation:
Department of Physical Education and Sports, Federal University of Alagoas, Maceio, Brazil
Matheus A. Pacheco
Affiliation:
Department of Medicine, Federal University of Santa Catarina, Florianopolis, Brazil
Isabela de C. Back*
Affiliation:
Postgraduate Program in Public Health, Federal University of Santa Catarina, Florianopolis, Brazil
*
Author for correspondence: Isabela de Carlos Back, PhD, Pediatric Cardiology, Professor of Program in Public Health, Federal University of Santa Catarina, Health Sciences Center, University Campus, Trindade, CEP 88040-900, Florianopolis, Santa Catarina, Brazil. Tel: +55 48 3721-9007. E-mail: isabela.c.back@gmail.com
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Abstract

Background:

Subclinical atherosclerosis in childhood can be evaluated by carotid intima-media thickness, which is considered a surrogate marker for atherosclerotic disease in adulthood. The aims of this study were to evaluate carotid intima-media thickness and, to investigate associated factors.

Methods:

Cross-sectional study with children and adolescents with congenital heart disease (CHD). Socio-demographic and clinical characteristics were assessed. Subclinical atherosclerosis was evaluated by carotid intima-media thickness. Cardiovascular risk factors, such as physical activity, screen time, passive smoke, systolic and diastolic blood pressure, waist circumference, dietary intake, lipid parameters, glycaemia, and C-reactive protein, were also assessed. Factors associated with carotid intima-media thickness were analysed using multiple logistic regression.

Results:

The mean carotid intima-media thickness was 0.518 mm and 46.7% had subclinical atherosclerosis (carotid intima-media thickness ≥ 97th percentile). After adjusting for confounding factors, cyanotic CHD (odds ratio: 0.40; 95% confidence interval: 0.20; 0.78), cardiac surgery (odds ratio: 3.17; 95% confidence interval: 1.35; 7.48), and be hospitalised to treat infections (odds ratio: 1.92; 95% confidence interval: 1.04; 3.54) were associated with subclinical atherosclerosis.

Conclusion:

Clinical characteristics related to CHD were associated with subclinical atherosclerosis. This finding suggests that the presence of CHD itself is a risk factor for subclinical atherosclerosis. Therefore, the screen and control of modifiable cardiovascular risk factors should be made early and intensively to prevent atherosclerosis.

Keywords

Congenital heart diseasesubclinical atherosclerosiscarotid intima-media thicknessrisk factorscardiovascular disease
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 631 - 638
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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