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Increased FH-Risk-Score and Diabetes Are Cardiovascular Risk Equivalents in Heterozygous Familial Hypercholesterolemia.
Paquette, Martine; Cariou, Bertrand; Bernard, Sophie; Hegele, Robert A; Gallo, Antonio; Genest, Jacques; Trinder, Mark; Brunham, Liam R; Béliard, Sophie; Baass, Alexis.
Afiliación
  • Paquette M; Lipids, Nutrition, and Cardiovascular Prevention Clinic of the Montreal Clinical Research Institute, Québec, Canada (M.P., S. Bernard, A.B.).
  • Cariou B; Nantes Université, CHU (Centre hospitalier universitaire) Nantes, CNRS (Centre national de la recherche scientifique), INSERM (L'Institut national de la santé et de la recherche médicale), L'institut Du Thorax, France (B.C.).
  • Bernard S; Lipids, Nutrition, and Cardiovascular Prevention Clinic of the Montreal Clinical Research Institute, Québec, Canada (M.P., S. Bernard, A.B.).
  • Hegele RA; Department of Medicine, Division of Endocrinology, Université de Montreal, Québec, Canada (S. Bernard).
  • Gallo A; Research Centre of the Centre Hospitalier Universitaire de Montréal, Québec, Canada (S. Bernard).
  • Genest J; Department of Medicine (R.A.H.), Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Trinder M; Department of Biochemistry (R.A.H.), Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Brunham LR; Robarts Research Institute (R.A.H.), Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Béliard S; Sorbonne Université, INSERM UMR1166, Lipidology and Cardiovascular Prevention Unit, Department of Nutrition, AP-HP (L'Assistance publique - hôpitaux de Paris), Hôpital Pitié-Salpètriêre, Paris, France (A.G.).
  • Baass A; Research Institute of the McGill University Health Centre, Montreal, Québec, Canada (J.G.).
Arterioscler Thromb Vasc Biol ; 44(2): 505-512, 2024 02.
Article en En | MEDLINE | ID: mdl-38031840
BACKGROUND: Familial hypercholesterolemia (FH) is a genetic condition causing premature atherosclerotic cardiovascular disease (ASCVD). It is well established that patients with FH should be treated with statin therapy. However, there exists discordance concerning low-density lipoprotein cholesterol-lowering goals in the management of these patients between different guidelines worldwide. The objective was to compare the 10-year ASCVD risk of different subgroups of patients with and without FH including those with diabetes or a history of ASCVD and patients with FH within different FH-Risk-Score categories. METHODS: This multinational observational study used data from 3 different prospective cohorts. A total of 3383 FH and 6917 non-FH controls matched for age and sex were included (104 363 person-years of follow-up). The 10-year incident ASCVD risk was assessed using Kaplan-Meier estimates, whereas the relative risk was estimated using Cox proportional hazards regression models. RESULTS: FH patients with a high (score >20%) FH-Risk-Score (hazard ratio, 8.45 [95% CI, 6.69-10.67]; P<0.0001), FH patients with diabetes (hazard ratio, 7.67 [95% CI, 4.82-12.21]; P<0.0001), and non-FH patients with ASCVD (hazard ratio, 6.78 [95% CI, 5.45-8.42]; P<0.0001) had a significantly higher incident ASCVD risk over 10 years than the reference group (non-FH without ASCVD or diabetes). The observed 10-year risks in these groups were 32.1%, 30.8%, 30.0%, and 5.1%, respectively. The 10-year ASCVD risk associated with both FH and ASCVD was extremely high (observed risk of 50.7%; hazard ratio, 14.53 [95% CI, 12.14-17.38]; P<0.0001). CONCLUSIONS: This study strongly suggests that the observed risk of FH patients with diabetes, history of ASCVD, and FH-Risk-Score >20% is as high or higher than non-FH individuals with a history of ASCVD. More aggressive management should be recommended for these patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Diabetes Mellitus / Aterosclerosis / Hiperlipoproteinemia Tipo II Límite: Female / Humans / Male Idioma: En Revista: Arterioscler Thromb Vasc Biol Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Diabetes Mellitus / Aterosclerosis / Hiperlipoproteinemia Tipo II Límite: Female / Humans / Male Idioma: En Revista: Arterioscler Thromb Vasc Biol Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos