S Béliard1, V Carreau2, A Carrié3, P Giral2, E Duchêne2, M Farnier4, J Ferrières5, A Fredenrich6, M Krempf7, G Luc8, P Moulin9, E Bruckert2. 1. Department of Endocrinology and Cardiovascular Disease Prevention, Institut of CardioMetabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, AP-HP, Paris 75013, France. Electronic address: sophie.beliard@psl.aphp.fr. 2. Department of Endocrinology and Cardiovascular Disease Prevention, Institut of CardioMetabolism And Nutrition (ICAN), La Pitié-Salpêtrière Hospital, AP-HP, Paris 75013, France. 3. Department of Biochemistry, La Pitié-Salpêtrière Hospital, Paris, France. 4. Point Médical, Dijon, France. 5. Department of Cardiology, Toulouse Rangueil University Hospital, Toulouse, France. 6. Department of Diabetology-Endocrinolgy, Pasteur University Hospital, Nice, France. 7. INSERM UMR 1087/CNRS UMR 6291, CNRH Nantes, Nantes, France. 8. Department of Internal Medicine, University Hospital, Faculty of Pharmacy, Lille, France. 9. Department of Endocrinology, Louis Pradel Cardiovascular Hospital, Lyon, France.
Abstract
BACKGROUND: Heterozygous Familial Hypercholesterolemia (heFH) is an autosomal disease that affects about 1/500 people. It is characterized by markedly elevated plasma LDL-cholesterol (C) levels and an increased risk of cardiovascular disease (CVD). The aim of this study was to measure changes in LDL-C levels in heFH patients over two decades, and to evaluate if patients achieved LDL-C targets. METHODS: Data from 1669 heFH patients in five academic French centers were recorded between 1988 and 2011. RESULTS: The mean LDL-C concentrations under medical care improved between 1988 and 2011 (245 mg/dL before 1995, 164 mg/dL after 2009; p < 0.0001). However, mean LDL-C level and the number of patients treated with statins (79.3%) have not improved since 2005. In patients registered and treated after 2005 (n = 616), only 10.4% reached target LDL-C levels of <100 mg/dL. Indeed, 29.4% (n = 181) were treated with a maximal therapy (statins with a potency of >45% LDL-C reduction plus at least another lipid-lowering agent). Despite maximal treatment, only 18.8% of these heFH patients (n = 34/181) reached target LDL-C levels of <100 mg/dL. In addition, 75.3% of patients with CVD did not reach the LDL-C of <100 mg/dL. CONCLUSION: This study demonstrates that after significant improvement over the past two decades, the mean LDL-C levels in heFH French patients has remained stable since 2005. We also show that most heFH patients are not achieving their recommended LDL-C goals: this highlights the need for improved treatment and for new therapeutics in this population.
BACKGROUND: Heterozygous Familial Hypercholesterolemia (heFH) is an autosomal disease that affects about 1/500 people. It is characterized by markedly elevated plasma LDL-cholesterol (C) levels and an increased risk of cardiovascular disease (CVD). The aim of this study was to measure changes in LDL-C levels in heFH patients over two decades, and to evaluate if patients achieved LDL-C targets. METHODS: Data from 1669 heFH patients in five academic French centers were recorded between 1988 and 2011. RESULTS: The mean LDL-C concentrations under medical care improved between 1988 and 2011 (245 mg/dL before 1995, 164 mg/dL after 2009; p < 0.0001). However, mean LDL-C level and the number of patients treated with statins (79.3%) have not improved since 2005. In patients registered and treated after 2005 (n = 616), only 10.4% reached target LDL-C levels of <100 mg/dL. Indeed, 29.4% (n = 181) were treated with a maximal therapy (statins with a potency of >45% LDL-C reduction plus at least another lipid-lowering agent). Despite maximal treatment, only 18.8% of these heFH patients (n = 34/181) reached target LDL-C levels of <100 mg/dL. In addition, 75.3% of patients with CVD did not reach the LDL-C of <100 mg/dL. CONCLUSION: This study demonstrates that after significant improvement over the past two decades, the mean LDL-C levels in heFH French patients has remained stable since 2005. We also show that most heFH patients are not achieving their recommended LDL-C goals: this highlights the need for improved treatment and for new therapeutics in this population.
Authors: Emil M deGoma; Zahid S Ahmad; Emily C O'Brien; Iris Kindt; Peter Shrader; Connie B Newman; Yashashwi Pokharel; Seth J Baum; Linda C Hemphill; Lisa C Hudgins; Catherine D Ahmed; Samuel S Gidding; Danielle Duffy; William Neal; Katherine Wilemon; Matthew T Roe; Daniel J Rader; Christie M Ballantyne; MacRae F Linton; P Barton Duell; Michael D Shapiro; Patrick M Moriarty; Joshua W Knowles Journal: Circ Cardiovasc Genet Date: 2016-03-24
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