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Characterising the lipid profile of paediatric patients with anomalous aortic origins of a coronary artery

Published online by Cambridge University Press:  21 November 2024

Thomas S. Przybycien Open the ORCID record for Thomas S. Przybycien [Opens in a new window] ,
Kimberly Gray ,
Sameer Sidiq ,
Sandra Mihail ,
Tam T. Doan Open the ORCID record for Tam T. Doan [Opens in a new window] ,
Shagun Sachdeva ,
Dana Reaves-O’Neal ,
Ziyad Binsalamah  and
Silvana Molossi Open the ORCID record for Silvana Molossi [Opens in a new window]
Thomas S. Przybycien
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
Kimberly Gray
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
Sameer Sidiq
Affiliation:
Baylor College of Medicine, Houston, Texas, USA
Sandra Mihail
Affiliation:
Baylor College of Medicine, Houston, Texas, USA
Tam T. Doan
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA Coronary Artery Anomalies Program, The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Houston, Texas, USA
Shagun Sachdeva
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA Coronary Artery Anomalies Program, The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Houston, Texas, USA
Dana Reaves-O’Neal
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA Coronary Artery Anomalies Program, The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Houston, Texas, USA
Ziyad Binsalamah
Affiliation:
Main Health Cardiovascular Surgery, Portland, Maine, USA
Silvana Molossi*
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA Coronary Artery Anomalies Program, The Lillie Frank Abercrombie Section of Cardiology, Texas Children’s Hospital, Houston, Texas, USA
*
Corresponding author: Silvana Molossi; Email: smolossi@bcm.edu
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Abstract

Background:

Lipid levels in paediatric patients with anomalous aortic origin of a coronary artery (AAOCA) have not previously been explored. Patients with CHD have an increased risk of atherosclerotic cardiovascular disease later in life compared to the general population. We aim to characterise the lipid profiles in paediatric patients with AAOCA and explore its relation to diagnosis, race/ethnicity, and exercise.

Methods:

Single institution retrospective cohort of 180 AAOCA paediatric patients (median age 13.7 years interquartile range 9.7–15.6, 66% male). Total cholesterol, HDL, LDL, triglycerides, total cholesterol to HDL ratio, and non-HDL cholesterol were evaluated across race/ethnicity, sex, type of AAOCA, documented ischaemia on imaging, exercise level, and surgery status. Normality of the data distribution for each lipid parameter was evaluated using Kolmogorov–Smirnov testing. Accordingly, Mann–Whitney U and t-tests were used to compare variables. The proportion of abnormal lipid levels by sex and race/ethnicity was calculated.

Results:

Total cholesterol was elevated in 29%, (51/177) of patients, HDL 37% (64/174), triglycerides 44% (72/165), LDL 16% (28/170), total cholesterol-HDL ratio 29%, (48/163), and non-HDL cholesterol 28% (47/165). Across subgroups categorised on the basis of surgery status, exercise level, AAOCA type, and sex, the mean and median levels for individual lipid parameters were normal. By race/ethnicity, Hispanic patients had significantly higher triglyceride (median 99, interquartile range 71–136.5, p = <0.001) and total cholesterol to HDL ratios (median 3.2, interquartile range 2.7–4.5, p = 0.014) versus non-Hispanic White and Black patients. Two-thirds of patients exercise recreationally.

Conclusion:

Hispanic patients have significantly elevated triglycerides and total cholesterol to HDL ratios compared to others. Longitudinal follow-up evaluating differences in long-term lipid status in patients with AAOCA and risk for cardiovascular events is warranted.

Keywords

Anomalous aortic origins of coronary arterieslipidscholesterolpaediatrics
Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 2 , February 2025 , pp. 311 - 316
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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