Prevalence of Coronary Artery Disease among Adult Patients with Congenital Heart Disease who Underwent Coronary Angiogram at the University of the Philippines-Philippine General Hospital from September 1998 to November 2011

Melgar O. Matulac, Felix Eduardo R. Punzalan, Richard Henry P. Tiongco, 
Paul Ferdinand M. Reganit, Wilbert Allan G. Gumatay and Maria Margarita O. Balabagno

Section of Cardiology, Department of Medicine, College of Medicine and
Philippine General Hospital, University of the Philippines Manila

Objectives. To determine prevalence of coronary artery disease (CAD) among adult patients with congenital heart disease (CHD), who underwent Coronary Angiography (CA) at the UP-PGH. Secondary: to determine severity of CAD lesions among these patients.

Methods. This is a descriptive study of adult patients with Congenital Heart Disease who underwent selective coronary angiography from September 1998 to December 2010 at the Philippine General Hospital.

Results. 52 adult patients with CHD underwent CA, Ten (19%) had angiographic evidence of coronary atherosclerosis visually. Significant CAD was found in 11.5% (n=6), all patients being >= 40 years old (mean age 54 +/- 7.9 years; range 47 -61); 4 (66%) are female; Five (83%) have documented traditional CVD risk factors, mostly hypertensive (33%). None with significant CAD had cyanosis, 4 patients (66%) have typical chest pain. Majority of CHD's were simple (61%), mostly atrial septal defects (36%). Four (n=4)(70%) patients with Simple CHD, 2 (30%) patients with Intermediate CHD and none of those with Complex CHD had significant CAD.

Conclusion. Prevalence of CAD among ACHD patients using CA in this study is 11.5%. This study supports the notion of routine CA among patients with ACHD >= 35 years old with traditional CV risk factors. Need for primary prevention of CAD and modification of traditional CV risk factors among these patients is emphasized, as important with the general population.

Keywords: adult congenital heart disease, coronary artery disease, prevalence