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Value of the Definition of Severe Familial Hypercholesterolemia for Stratification of Heterozygous Patients.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2017 Mar 01; Vol. 119 (5), pp. 742-748. Date of Electronic Publication: 2016 Dec 02. - Publication Year :
- 2017
-
Abstract
- Familial hypercholesterolemia (FH) is characterized by high low-density lipoprotein (LDL) cholesterol with co-dominant transmission and high risk of cardiovascular disease (CVD), although with high variability among subjects. Currently, CVD stratification tools for heterozygous FH (HeFH) are not available. A definition of severe HeFH has been recently proposed by the International Atherosclerosis Society (IAS), but it has not been validated. Our study aims to see clinical characteristics and prevalence of CVD in subjects defined as severe HeFH by IAS criteria. Probable or definite HeFH introduced in the Dyslipidemia Registry of Spanish Arteriosclerosis Society were analyzed by the IAS criteria. Univariate and multivariate analysis was used to assess the association of CVD with the IAS criteria. About 1,732 HeFH cases were analyzed. Severe HeFH had higher prevalence of familial history of CVD, personal history of tendon xanthomas, LDL cholesterol, and CVD than nonsevere HeFH. A total of 656 (77.1%) and 441 (50.1%) of men and women, respectively, fulfilled the IAS criteria of severe HeFH. In the univariate analysis, subjects defined as severe HeFH showed odds ratio 3.016 (95% CI 3.136 to 4.257, p <0.001) for CVD. However, when traditional risk factors were included in the multivariate analysis, only the presence of cholesterol >400 mg/dl had a statistically significant association with CVD odds ratio 8.76 (95% CI 3.90 to 19.69, p <0.001). In conclusion, the IAS definition of severe HeFH is not significantly associated with CVD when adjusted for classic risk factors. Risk stratification in HeFH is an important issue, but the proposed criteria do not seem to solve this problem.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Cholesterol, LDL blood
Female
Heterozygote
Humans
Hyperlipoproteinemia Type II blood
Hyperlipoproteinemia Type II classification
Hyperlipoproteinemia Type II genetics
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prevalence
Risk Assessment
Severity of Illness Index
Cardiovascular Diseases epidemiology
Hyperlipoproteinemia Type II epidemiology
Muscular Diseases epidemiology
Tendons
Xanthomatosis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 119
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 28081939
- Full Text :
- https://doi.org/10.1016/j.amjcard.2016.11.025