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Coronary heart disease mortality in treated familial hypercholesterolaemia: Update of the UK Simon Broome FH register.
Humphries, S E; Cooper, J A; Seed, M; Capps, N; Durrington, P N; Jones, B; McDowell, I F W; Soran, H; Neil, H A W.
Afiliación
  • Humphries SE; Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, University Street, London, WC1E 6JJ, UK. Electronic address: steve.humphries@ucl.ac.uk.
  • Cooper JA; Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, University Street, London, WC1E 6JJ, UK.
  • Seed M; Department of Cardiology, Imperial College Faculty of Medicine, Charing Cross Campus, University of London, UK.
  • Capps N; Department of Clinical Biochemistry, The Shrewsbury and Telford Hospital NHS Trust, Princess Royal Hospital, Telford, UK.
  • Durrington PN; Cardiovascular Research Group, School of Clinical and Laboratory Sciences, University of Manchester, UK.
  • Jones B; Section of Investigative Medicine, Imperial College London, UK.
  • McDowell IFW; Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff, UK.
  • Soran H; Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
  • Neil HAW; Wolfson College, University of Oxford, UK.
Atherosclerosis ; 274: 41-46, 2018 07.
Article en En | MEDLINE | ID: mdl-29751283
BACKGROUND AND AIMS: Patients with familial hypercholesterolaemia (FH) have an elevated risk of coronary heart disease (CHD). Here we compare changes in CHD mortality in patients with heterozygous (FH) pre 1992, before lipid-lowering therapy with statins was used routinely, and in the periods 1992-2008 and 2008-2016. METHODS: 1903 Definite (DFH) and 1650 Possible (PFH) patients (51% women) aged 20-79 years, recruited from 21 lipid clinics in the United Kingdom and followed prospectively between 1980 and 2016 for 67,060 person-years. The CHD standardised mortality ratio (SMR) compared to the population in England and Wales was calculated (with 95% Confidence intervals). RESULTS: There were 585 deaths, including 252 from CHD. Overall, the observed 2.4-fold excess coronary mortality for treated DFH post-1991 was significantly higher than the 1.78 excess for PFH (35% 95% CI 3%-76%). In patients with DFH and established coronary disease, there was a significant excess coronary mortality in all time periods, but in men it was reduced from a 4.83-fold excess (2.32-8.89) pre-1992 to 4.66 (3.46-6.14) in 1992-2008 and 2.51 (1.01-5.17) post-2008, while in women the corresponding values were 7.23 (2.65-15.73), 4.42 (2.70-6.82) and 6.34 (2.06-14.81). Primary prevention in men with DFH resulted in a progressive reduction in coronary mortality over the three time-periods, with no excess mortality evident post-2008 (0.89 (0.29-2.08)), although in women the excess persisted (post-2008 3.65 (1.75-6.72)). CONCLUSIONS: The results confirm the benefit of statin treatment in reducing CHD mortality, but suggest that FH patients with pre-existing CHD and women with FH may not be treated adequately.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prevención Primaria / Colesterol / Inhibidores de Hidroximetilglutaril-CoA Reductasas / Enfermedad Coronaria / Hiperlipoproteinemia Tipo II Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Atherosclerosis Año: 2018 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prevención Primaria / Colesterol / Inhibidores de Hidroximetilglutaril-CoA Reductasas / Enfermedad Coronaria / Hiperlipoproteinemia Tipo II Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Atherosclerosis Año: 2018 Tipo del documento: Article Pais de publicación: Irlanda