Lipid Screening and Dyslipidemia in Children with Congenital Heart Disease

Dyslipidemia is associated with increased risk for atherosclerosis and cardiovascular events in adulthood. Atherosclerosis begins in childhood and guidelines exist to screen for at-risk children. Children with congenital heart disease (CHD) have high lifetime cardiovascular risk but data are limited on their rates of dyslipidemia. Our study aims to detail rates of lipid screening and dyslipidemia in children with CHD. Children with CHD aged 9-18 years who followed at our institution from 2012 to 2019 were included. Subjects were classified as dyslipidemic if they met one of the following: total cholesterol ≥ 200 mg/dL, low-density lipoprotein-C ≥ 130 mg/dL, triglycerides ≥ 130 mg/dL, high-density lipoprotein cholesterol [HDL-C] < 40 mg/dL, non-HDL-C ≥ 145 mg/dL. Of 1579 patients, only 11.3% (N = 179/1579) had a documented lipid panel. Of those screened, 60% (N = 107/179) had dyslipidemia. Screened subjects had higher median BMI percentiles versus unscreened (84th vs. 64th ). Dyslipidemic subjects had higher median BMI percentiles compared to those without (92nd vs. 74th ). Black patients were a higher proportion of the screened population compared to unscreened (26% vs. 11%). Overall, there were similar rates of dyslipidemia across all races and CHD lesions. Only a small proportion of children with CHD had lipid screening performed despite universal screening guidelines. However, a sizable percentage of children screened had dyslipidemia. Screening favored Black patients and those with higher BMI. Higher BMI patients had increased rates of dyslipidemia. These findings emphasize the importance of universal screening for dyslipidemia in children with CHD.