Attainment of the low-density lipoprotein cholesterol treatment target and prognosis of heterozygous familial hypercholesterolemia. (April 2023)

• Record Type: Journal Article
• Authors: Tada, Hayato; Nomura, Akihiro; Nohara, Atsushi; Usui, Soichiro; Sakata, Kenji; Hayashi, Kenshi; Fujino, Noboru; Takamura, Masayuki; Kawashiri, Masa-aki
• Is Part Of: Atherosclerosis. Volume 371(2023)
• Page Start: 61
• Page End: 66
• Publication Date: 2023-04
• Subjects: Familial hypercholesterolemia -- LDL cholesterol -- Genetics -- LDL receptor -- Guideline; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2023.03.005
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: No previous study has investigated the association between attainment of low-density lipoprotein (LDL) cholesterol treatment target and better prognosis in patients with familial hypercholesterolemia (FH). The current research aimed to examine the association between attainment of LDL cholesterol treatment target and major adverse cardiac events (MACEs) in patients with FH to validate the current LDL cholesterol treatment targets in primary (<100 mg/dL) and secondary (<70 mg/dL) prevention settings. Methods: The data of patients with FH who were admitted to Kanazawa University Hospital between 2000 and 2020 and who were followed-up were retrospectively reviewed. The number of MACEs, including mortality associated with cardiovascular disease, unstable angina, and myocardial infarction per 1000 person-years, was calculated for each stratum for the attainment of LDL cholesterol target. Results: The median follow-up duration was 12.6 years. In total, 132 MACEs were recorded during the follow-up period. The numbers of patients who attained the LDL cholesterol target in the primary and secondary prevention groups were 228 (31.9%) and 40 (11.9%), respectively. The event rates per 1000 person-years for LDL cholesterol levels of <100 and ≥100 mg/dL in the primary prevention group were 2.6 and 4.4, respectively. The event rates per 1000 person-years for LDL cholesterol levels of <70 and ≥70 mg/dL in the secondary prevention group were 15.3 and 27.5, respectively. Conclusions: Attainment of the LDL cholesterol target is associated with better prognosis in patients with FH. However, the attainment rate is currently inadequate among Japanese. Graphical abstract: Image 1 Highlights: Attainment of the LDL cholesterol target is currently inadequate in FH. Attainment of the LDL cholesterol target is associated with better prognosis in FH. PCSK9 inhibitor is associated with better attainment rate of the LDL cholesterol target.