Jing Pang1, Elissa B Poulter1, Damon A Bell2, Timothy R Bates3, Vicki-Lee Jefferson1, Graham S Hillis4, Carl J Schultz4, Gerald F Watts5. 1. School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia. 2. School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, Western Australia, Australia; Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital, Western Australia, Australia. 3. School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, Western Australia, Australia. 4. School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Western Australia, Australia. 5. School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, Western Australia, Australia. Electronic address: gerald.watts@uwa.edu.au.
Abstract
BACKGROUND: Familial hypercholesterolemia (FH) is the most common dominantly inherited cause of premature coronary artery disease (CAD). However, the diagnosis of FH in patients who have premature CAD in hospital settings is under-recognized, this also represents a missed opportunity for screening their close family members and implementing primary prevention. OBJECTIVE: To investigate the point prevalence of FH in a coronary care unit (CCU) among patients with early-onset CAD. METHODS: The prevalence of FH, based on modified phenotypic Dutch Lipid Clinic Network Criteria, and the spectrum of associated CAD risk factors, were investigated in a CCU setting. Data were collected on 175 coronary care patients with onset of CAD at age <60 years. RESULTS: The prevalence of probable/definite FH was 14.3% (95% confidence interval, 9.0%-19.5%); 46.3% of the patients gave a family history of premature CAD and 20.6% had an untreated low-density lipoprotein cholesterol >5.0 mmol/L. Diabetes, hypertension, obesity, and smoking were common and equally prevalent in patients with and without FH. CONCLUSIONS: FH is relatively frequent among patients with a history of early-onset CAD in the CCU. Every effort should be made to detect FH in these patients and to initiate cascade testing of available family members to prevent the development of CAD in those who may be unaware that they also have the condition.
BACKGROUND:Familial hypercholesterolemia (FH) is the most common dominantly inherited cause of premature coronary artery disease (CAD). However, the diagnosis of FH in patients who have premature CAD in hospital settings is under-recognized, this also represents a missed opportunity for screening their close family members and implementing primary prevention. OBJECTIVE: To investigate the point prevalence of FH in a coronary care unit (CCU) among patients with early-onset CAD. METHODS: The prevalence of FH, based on modified phenotypic Dutch Lipid Clinic Network Criteria, and the spectrum of associated CAD risk factors, were investigated in a CCU setting. Data were collected on 175 coronary care patients with onset of CAD at age <60 years. RESULTS: The prevalence of probable/definite FH was 14.3% (95% confidence interval, 9.0%-19.5%); 46.3% of the patients gave a family history of premature CAD and 20.6% had an untreated low-density lipoprotein cholesterol >5.0 mmol/L. Diabetes, hypertension, obesity, and smoking were common and equally prevalent in patients with and without FH. CONCLUSIONS:FH is relatively frequent among patients with a history of early-onset CAD in the CCU. Every effort should be made to detect FH in these patients and to initiate cascade testing of available family members to prevent the development of CAD in those who may be unaware that they also have the condition.
Authors: Katrina L Ellis; Jing Pang; David Chieng; Damon A Bell; John R Burnett; Carl J Schultz; Graham S Hillis; Gerald F Watts Journal: Clin Cardiol Date: 2018-02-26 Impact factor: 2.882
Authors: Christoph Nowak; Axel C Carlsson; Carl Johan Östgren; Fredrik H Nyström; Moudud Alam; Tobias Feldreich; Johan Sundström; Juan-Jesus Carrero; Jerzy Leppert; Pär Hedberg; Egil Henriksen; Antonio C Cordeiro; Vilmantas Giedraitis; Lars Lind; Erik Ingelsson; Tove Fall; Johan Ärnlöv Journal: Diabetologia Date: 2018-05-24 Impact factor: 10.122