Low-density lipoprotein cholesterol goal attainment in patients with clinical evidence of familial hypercholesterolemia and elevated Lp(a)

Lipids in Health and Disease

卷:21

Research

Arash Haghikia¹  Ulf Landmesser¹  Maximilian König²  Ilja Demuth³  Andrea Schwarz⁴  Elisabeth Steinhagen-Thiessen⁵ 

[1] Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany;Department of Cardiology, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany;German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany;

[2] Department of Endocrinology and Metabolic Diseases (Including Division of Lipid Metabolism), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Biology of Aging Working Group, Augustenburger Platz 1, 13353, Berlin, Germany;

[3] Department of Endocrinology and Metabolic Diseases (Including Division of Lipid Metabolism), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Biology of Aging Working Group, Augustenburger Platz 1, 13353, Berlin, Germany;BCRT – Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany;

[4] Department of Endocrinology and Metabolic Diseases (Including Division of Lipid Metabolism), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Biology of Aging Working Group, Augustenburger Platz 1, 13353, Berlin, Germany;Department of Pediatrics, Charité -Universitätsmedizin Berlin, Division of Cardiology, Berlin, Germany;

[5] Department of Endocrinology and Metabolic Diseases (Including Division of Lipid Metabolism), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Biology of Aging Working Group, Augustenburger Platz 1, 13353, Berlin, Germany;Institute of Clinical Chemistry and Laboratory Medicine, University of Rostock, Rostock, Germany;

关键词: LDL-cholesterol;    Treatment goal achievement;    Familial hypercholesterolemia;    Lipoprotein (a);    Coronary artery disease;    Lipid-lowering treatment;    Family history;   

DOI  :  10.1186/s12944-022-01708-9

 received in 2022-08-05, accepted in 2022-09-26,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAlthough potent lipid-lowering therapies are available, patients commonly fall short of recommended low-density lipoprotein cholesterol (LDL-C) levels. The aim of this study was to examine the relationship between familial hypercholesterolemia (FH) and elevated lipoprotein(a) [Lp(a)] and LDL-C goal attainment, as well as the prevalence and severity of coronary artery disease (CAD). Moreover, we characterized patients failing to meet recommended LDL-C goals.MethodsWe performed a cross-sectional analysis in a cohort of patients undergoing cardiac catheterization. Clinical FH was determined by the Dutch Clinical Lipid Network Score, and Lp(a) ≥ 50 mg/dL (≈ 107 nmol/L) was considered elevated.ResultsA total of 838 participants were included. Overall, the prevalence of CAD was 72%, and 62% received lipid-lowering treatment. The prevalence of clinical FH (probable and definite FH) was 4%, and 19% had elevated Lp(a) levels. With 35%, LDL-C goal attainment was generally poor. Among the participants with clinical FH, none reached their LDL-C target. Among patients with elevated Lp(a), LDL-C target achievement was only 28%. The prevalence and severity of CAD were higher in participants with clinical FH (86% prevalence) and elevated Lp(a) (80% prevalence).ConclusionMost participants failed to meet their individual LDL-C goals according to the ESC 2016 and 2019 guidelines. In particular, high-risk patients with clinical FH or elevated Lp(a) rarely met their target for LDL-C. The identification of these patients and more intense treatment approaches are crucial for the improvement of CAD primary and secondary prevention.

【 授权许可】

CC BY   
© The Author(s) 2022

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