Search for familial hypercholesterolemia patients in an Italian community : A real-life retrospective study
Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved..
BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is a common inherited disorder of low-density lipoprotein (LDL) catabolism that causes elevated LDL-cholesterol (LDL-C) and premature atherosclerotic cardiovascular disease (ASCVD). Despite the availability of effective treatments, FH remains underdiagnosed and undertreated. The aims of the study were to identify putative FH subjects using data from laboratory and cardiology databases, genetically characterize suspected FH patients referred to the Lipid Clinic and monitor attainment of treatment goals in identified patients.
METHODS AND RESULTS: We retrieved the electronic health records of 221,644 individuals referred to laboratory for routine assessment and of 583 ASCVD patients (age ≤65) who underwent percutaneous transluminal coronary angioplasty (PTCA). We monitored the lipid profiles of subjects with LDL-C ≥ 250 mg/dl identified by laboratory survey (LS-P), PTCA patients and patients from the Lipid Clinic (LC-P). The laboratory survey identified 1.46% of subjects with LDL-C ≥ 190 mg/dl and 0.08% with LDL-C ≥ 250 mg/dl. Probable/definite FH was suspected in 3% of PTCA patients. Molecularly-confirmed FH was found in 44% of LC-P subjects. Five new LDLR mutations were identified. The 50% LDL-C reduction target was achieved by 70.6% of LC-P patients. Only 18.5% of PTCA patients reached the LDL-C < 55 mg/dl target.
CONCLUSION: By using a combined approach based on laboratory lipid profiles, documented ASCVD and Lipid Clinic data, we were able to identify subjects with a high probability of being FH. Attainment of LDL-C goals was largely suboptimal. Efforts are needed to improve FH detection and achievement of lipid targets.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Nutrition, metabolism, and cardiovascular diseases : NMCD - 32(2022), 3 vom: 15. März, Seite 577-585 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fasano, Tommaso [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 10.03.2022 Date Revised 11.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.numecd.2021.12.024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336563884 |
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| 041 | |a eng | ||
| 100 | 1 | |a Fasano, Tommaso |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Search for familial hypercholesterolemia patients in an Italian community |b A real-life retrospective study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 11.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is a common inherited disorder of low-density lipoprotein (LDL) catabolism that causes elevated LDL-cholesterol (LDL-C) and premature atherosclerotic cardiovascular disease (ASCVD). Despite the availability of effective treatments, FH remains underdiagnosed and undertreated. The aims of the study were to identify putative FH subjects using data from laboratory and cardiology databases, genetically characterize suspected FH patients referred to the Lipid Clinic and monitor attainment of treatment goals in identified patients | ||
| 520 | |a METHODS AND RESULTS: We retrieved the electronic health records of 221,644 individuals referred to laboratory for routine assessment and of 583 ASCVD patients (age ≤65) who underwent percutaneous transluminal coronary angioplasty (PTCA). We monitored the lipid profiles of subjects with LDL-C ≥ 250 mg/dl identified by laboratory survey (LS-P), PTCA patients and patients from the Lipid Clinic (LC-P). The laboratory survey identified 1.46% of subjects with LDL-C ≥ 190 mg/dl and 0.08% with LDL-C ≥ 250 mg/dl. Probable/definite FH was suspected in 3% of PTCA patients. Molecularly-confirmed FH was found in 44% of LC-P subjects. Five new LDLR mutations were identified. The 50% LDL-C reduction target was achieved by 70.6% of LC-P patients. Only 18.5% of PTCA patients reached the LDL-C < 55 mg/dl target | ||
| 520 | |a CONCLUSION: By using a combined approach based on laboratory lipid profiles, documented ASCVD and Lipid Clinic data, we were able to identify subjects with a high probability of being FH. Attainment of LDL-C goals was largely suboptimal. Efforts are needed to improve FH detection and achievement of lipid targets | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Atherosclerotic Cardiovascular Disease (ASCVD) | |
| 650 | 4 | |a Dutch Lipid Clinic Network (DLCN) score | |
| 650 | 4 | |a ESC/EAS guidelines | |
| 650 | 4 | |a Familial Hypercholesterolemia | |
| 650 | 4 | |a Low-Density Lipoprotein Cholesterol (LDL-C) | |
| 650 | 7 | |a Cholesterol, LDL |2 NLM | |
| 700 | 1 | |a Trenti, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Negri, Emanuele A |e verfasserin |4 aut | |
| 700 | 1 | |a Guiducci, Vincenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Foracchia, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Bonelli, Efrem |e verfasserin |4 aut | |
| 700 | 1 | |a Canovi, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Besutti, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Bertolini, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Calandra, Sebastiano |e verfasserin |4 aut | |
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