LDL-cholesterol goal achievement, cardiovascular disease, and attributed risk of Lp(a) in a large cohort of predominantly genetically verified familial hypercholesterolemia

被引：44

作者：

Bogsrud, Martin P. ^{[1
,2
,3
]}

Graesdal, Asgeir ^{[4
]}

Johansen, Dan ^{[1
]}

Langslet, Gisle ^{[1
,2
]}

Hovland, Anders ^{[1
,5
,6
]}

Arnesen, Kjell-Erik ^{[2
]}

Mundal, Liv J. ^{[2
]}

Retterstol, Kjetil ^{[2
,7
]}

Wium, Cecilie ^{[2
]}

Holven, Kirsten B. ^{[7
]}

机构：

[1] Oslo Univ Hosp, Dept Endocrinol Morbid Obes & Prevent Med, Norwegian Natl Advisory Unit Familial Hypercholes, Oslo, Norway

[2] Oslo Univ Hosp, Dept Endocrinol Morbid Obes & Prevent Med, Lipid Clin, Oslo, Norway

[3] Oslo Univ Hosp, Dept Med Genet, Unit Cardiac & Cardiovasc Genet, Oslo, Norway

[4] Vestfold Med Ctr, Sandefjord, Norway

[5] Nordland Hosp Bodo, Div Internal Med, Bodo, Norway

[6] Univ Tromso, Dept Clin Med, Tromso, Norway

[7] Univ Oslo, Inst Basic Med Sci, Dept Nutr, Fac Med, Oslo, Norway

来源：

JOURNAL OF CLINICAL LIPIDOLOGY | 2019年 / 13卷 / 02期

关键词：

Familial hypercholesterolemia; LDL-cholesterol; Treatment goal achievement; Proprotein convertase subtilisin/kexin type 9 (PCSK9); Lipoprotein (a); LIPOPROTEIN(A) LEVELS; STATIN THERAPY; EVOLOCUMAB; SYMPTOMS; STENOSIS; SAFETY;

D O I：

10.1016/j.jacl.2019.01.010

中图分类号：

R9 [药学];

学科分类号：

100702 [药剂学];

摘要：

BACKGROUND: Current treatment goals for familial hypercholesterolemia (FH) recommended by the European Atherosclerosis Society (EAS) are LDL-C <= 2.5 mmol/L (similar to 100 mg/dL) or <= 1.8 mmol/L (similar to 70 mg/dL) in very high-risk subjects. OBJECTIVE: The objective of the present study was to investigate characteristics and treatment status in subjects with genetically verified FH followed at specialized lipid clinics in Norway. METHODS: Data from treatment registries of 714 adult (>18 years) subjects with FH. RESULTS: Fifty-seven percent were female. Mean age (SD) at last visit was 44 (16.3) years, and the subjects had been followed at a lipid clinic for 11.1 (7.9) years. Two hundred forty-five (34%) were classified as very-high-risk, and 44% of these had established coronary heart disease. Very-high-risk FH subjects more often received maximal statin dose (54% vs 33%, P<.001), ezetimibe (76% vs 48%, P<.001) or resins (23% vs 9%, P<.001), and achieved LDL-C was lower (3.2 vs 3.5 mmol/L [124 vs 135 mg/dL], P=.003) than normal-risk FH. LDL-C treatment goal was achieved in 25% and 8% of subjects with normal -riskand very-high-risk FH, respectively. Lp(a) levels were available in 599 subjects, and they were divided into 2 groups: mg/dL (n = 96) and <90 mg/dL (n = 503). Despite similar lipid levels, body mass index, smoking status, presence of diabetes, and blood pressure, prevalence of coronary heart disease was doubled in the high-compared to low-Lp(a) group (30% vs 14%, P<.001). CONCLUSION: Very few FH subjects achieve their LDL-C treatment goal. New treatment modalities are needed. Independent of LDL-C and other risk factors, high Lp(a) seem to be an important additional risk factor in genetically verified FH. (C) 2019 National Lipid Association. All rights reserved.

引用

页码：279 / 286

页数：8

共 27 条

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Lipoprotein(a) Levels in Familial Hypercholesterolemia An Important Predictor of Cardiovascular Disease Independent of the Type of LDL Receptor Mutation [J].