Attainment of LDL-Cholesterol Treatment Goals in Patients With Familial Hypercholesterolemia: 5-Year SAFEHEART Registry Follow-Up. - PubMed - NCBI

Attainment of LDL-Cholesterol Treatment Goals in Patients With Familial Hypercholesterolemia: 5-Year SAFEHEART Registry Follow-Up. - PubMed - NCBI

J Am Coll Cardiol. 2016 Mar 22;67(11):1278-85. doi: 10.1016/j.jacc.2016.01.008.

Attainment of LDL-Cholesterol Treatment Goals in Patients With Familial Hypercholesterolemia: 5-Year SAFEHEART Registry Follow-Up.

Perez de Isla L1, Alonso R2, Watts GF3, Mata N4, Saltijeral Cerezo A5, Muñiz O6, Fuentes F7, Diaz-Diaz JL8, de Andrés R9, Zambón D10, Rubio-Marin P11,Barba-Romero MA12, Saenz P13, Sanchez Muñoz-Torrero JF14, Martinez-Faedo C15, Miramontes-Gonzalez JP16, Badimón L17, Mata P18; SAFEHEART Investigators.

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Author information

Abstract

BACKGROUND:

Familial hypercholesterolemia (FH) is the most common genetic disorder associated with premature atherosclerotic cardiovascular disease (ASCVD). There are sparse data on attainment of treatment targets; large registries that reflect real-life clinical practice can uniquely provide this information.

OBJECTIVES:

We sought to evaluate the achievement of low-density lipoprotein cholesterol (LDL-C) treatment goals in FH patients enrolled in a large national registry.

METHODS:

The SAFEHEART study (Spanish Familial Hypercholesterolemia Cohort Study) is a large, ongoing registry of molecularly defined patients with heterozygous FH treated in Spain. The attainment of guideline-recommended plasma LDL-C goals at entry and follow-up was investigated in relation to use of lipid-lowering therapy (LLT).

RESULTS:

The study recruited 4,132 individuals (3,745 of whom were ≥18 years of age); 2,752 of those enrolled were molecularly diagnosed FH cases. Mean follow-up was 5.1 ± 3.1 years; 71.8% of FH cases were on maximal LLT, and an LDL-C treatment target <100 mg/dl was reached by only 11.2% of patients. At follow-up, there was a significant increase in the use of ezetimibe, drug combinations with statins, and maximal LLT. The presence of type 2 diabetes mellitus, a defective allele mutation, ezetimibe use, and the absence of previous ASCVD were predictors of the attainment of LDL-C goals.

CONCLUSIONS:

Despite the use of intensified LLT, many FH patients continue to experience high plasma LDL-C levels and, consequently, do not achieve recommended treatment targets. Type of LDL-receptor mutation, use of ezetimibe, coexistent diabetes, and ASCVD status can bear significantly on the likelihood of attaining LDL-C treatment goals.

Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

LDL-receptor mutations; cardiovascular disease; lipid-lowering therapy; low-density lipoprotein cholesterol

Comment in

• Improving the Monitoring and Care of Patients With Familial Hypercholesterolemia. [J Am Coll Cardiol. 2016]

PMID:

 

26988947

 

DOI:

 

10.1016/j.jacc.2016.01.008

[PubMed - indexed for MEDLINE]

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  Wang Anthony et al. Journal of the American Heart Association 2016 5(7)
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