Nina Schmidt1, Alexander Dressel2, Tanja B Grammer3, Ioanna Gouni-Berthold4, Ulrich Julius5, Ursula Kassner6, Gerald Klose7, Christel König8, Wolfgang Koenig9, Britta Otte10, Klaus G Parhofer10, Wibke Reinhard9, Ulrike Schatz5, Heribert Schunkert9, Elisabeth Steinhagen-Thiessen6, Anja Vogt11, Ulrich Laufs12, Winfried März13. 1. D A CH Society for the Prevention of Heart and Circulatory Diseases (registered society), Hamburg, Germany. Electronic address: nina.schmidt@carehigh.de. 2. D A CH Society for the Prevention of Heart and Circulatory Diseases (registered society), Hamburg, Germany. 3. Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany; Department of Internal Medicine V Medical Faculty Mannheim, Heidelberg University, Germany. 4. Polyclinic for Endocrinology, Diabetes, and Preventive Medicine, University of Cologne, Germany. 5. Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany. 6. Center for Internal Medicine with Gastroenterology and Nephrology, Lipid Clinic, Charité, Berlin, Germany. 7. Joint Practice for Internal Medicine, Gastroenterology and Cardiology Beckenbauer & Maierhof, Bremen, Germany. 8. Clinic of Internal Medicine, Lipid Clinic, Klinikum Links der Weser, Bremen, Germany. 9. Clinic for Heart and Circulatory Diseases, German Heart Center Munich, Technical University Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. 10. Medical Clinic D, Lipid Clinic, University Hospital Münster, Germany. 11. Medical Clinic and Polyclinic IV, Ludwig-Maximilian University, Munich, Germany. 12. Clinic for Internal Medicine III (Cardiology, Angiology and Medical Intensive Care), University of Saarland, Homburg, Germany; Clinic and Policlinic for Cardiology, Department for Internal Medicine, Neurology and Dermatology, University Hospital Leipzig, Germany. 13. D A CH Society for the Prevention of Heart and Circulatory Diseases (registered society), Hamburg, Germany; Department of Internal Medicine V Medical Faculty Mannheim, Heidelberg University, Germany; Klinisches Institut für Medizinische und Chemische Labordiagnostik, Medizinische Universität Graz, Graz, Austria; Synlab Akademie, Synlab Holding Deutschland GmbH, Mannheim und Augsburg, Germany.
Abstract
BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is amongst the most common genetic disorders encountered in primary care. Yet, only a minority of affected patients is diagnosed and treated. This interim analysis of the CaRe High Registry aims at examining the state of treatment and attainment of lipid goals in German FH patients. METHODS: The CaRe High registry includes FH patients from lipid clinics and private practices. Data have been collected using questionnaires filled in by the recruiting physicians and by interviewing the participating patients. RESULTS: We examined 512 F H patients diagnosed according to clinical criteria. Median age at the time of the first FH diagnosis was 39 (25th and 75th percentile: 27-50) years, median treatment naïve LDL cholesterol (LDL-C) was 239.4 mg/dl (6.19 mmol/l), 25th to 75th percentile 191.8-342.5 mg/dl (4.96-8.86 mmol/l). 27% of the participants did not receive lipid-lowering drugs. Among the patients treated with lipid-lowering drugs, 19% received a PCSK9 inhibitor (PCSK9i) in combination with a statin, 9% were treated with a PCSK9i alone and 3% were treated with a combination of PCSK9i and a non-statin drug. Patients with pre-existing CVD were more likely to be treated with lipid-lowering drugs and more likely to receive a PCSK9i, but LDL-C targets were only achieved by a minority of patients (<20%). Gap to target LDL-C was lowest and the median achieved LDL-C reduction was 1.4 times higher with PCSK9i treatment than with (oral) lipid-lowering therapy without PCSK9i. CONCLUSIONS: The Care High registry has included patients with the typical clinical features of familial hypercholesterolemia. PCSK9i treatment in addition to standard therapy allows attainment of target values in many patients with initially very high LDL-C.
BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is amongst the most common genetic disorders encountered in primary care. Yet, only a minority of affected patients is diagnosed and treated. This interim analysis of the CaRe High Registry aims at examining the state of treatment and attainment of lipid goals in German FH patients. METHODS: The CaRe High registry includes FH patients from lipid clinics and private practices. Data have been collected using questionnaires filled in by the recruiting physicians and by interviewing the participating patients. RESULTS: We examined 512 F H patients diagnosed according to clinical criteria. Median age at the time of the first FH diagnosis was 39 (25th and 75th percentile: 27-50) years, median treatment naïve LDL cholesterol (LDL-C) was 239.4 mg/dl (6.19 mmol/l), 25th to 75th percentile 191.8-342.5 mg/dl (4.96-8.86 mmol/l). 27% of the participants did not receive lipid-lowering drugs. Among the patients treated with lipid-lowering drugs, 19% received a PCSK9 inhibitor (PCSK9i) in combination with a statin, 9% were treated with a PCSK9i alone and 3% were treated with a combination of PCSK9i and a non-statin drug. Patients with pre-existing CVD were more likely to be treated with lipid-lowering drugs and more likely to receive a PCSK9i, but LDL-C targets were only achieved by a minority of patients (<20%). Gap to target LDL-C was lowest and the median achieved LDL-C reduction was 1.4 times higher with PCSK9i treatment than with (oral) lipid-lowering therapy without PCSK9i. CONCLUSIONS: The Care High registry has included patients with the typical clinical features of familial hypercholesterolemia. PCSK9i treatment in addition to standard therapy allows attainment of target values in many patients with initially very high LDL-C.
Authors: Anselm K Gitt; Ulrich Laufs; Winfried März; W Dieter Paar; Peter Bramlage; Nikolaus Marx; Klaus G Parhofer Journal: J Clin Med Date: 2022-06-30 Impact factor: 4.964
Authors: Veronika Sanin; Raphael Schmieder; Sara Ates; Lea Dewi Schlieben; Jens Wiehler; Ruoyu Sun; Manuela Decker; Michaela Sander; Stefan Holdenrieder; Florian Kohlmayer; Anna Friedmann; Volker Mall; Therese Feiler; Arne Dreßler; Tim M Strom; Holger Prokisch; Thomas Meitinger; Moritz von Scheidt; Wolfgang Koenig; Georg Leipold; Heribert Schunkert Journal: Eur J Public Health Date: 2022-06-01 Impact factor: 4.424