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The very high cardiovascular risk in heterozygous familial ă hypercholesterolemia: Analysis of 734 French patients
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International audience. BACKGROUND: Heterozygous familial hypercholesterolemia (heFH) is a ă genetic disease causing high levels of low-density lipoprotein ă cholesterol (LDL-C). Although this population is at high cardiovascular ă (CV) risk, the risk is variable within patients depending on additional ă risk factors. CV disease risk groups have been defined by the Nouvelle ă Societe Francophone d'Atherosclerose (NSFA) and by the National Lipid ă Association recommendations. ă OBJECTIVES: The study aimed to describe a sample of French heFH ă patients, comparing patients at very high risk (VHR) and patients at ă high risk in terms of demographic and clinical characteristics as well ă as biological measurements and disease management. ă METHODS: Cross-sectional retrospective analysis on 734 patients ă hospitalized after 2005 in 5 academic centers. ă RESULTS: When considering NSFA classification, 550 (74.9%) patients ă belonged to the VHR group. Most patients in the VHR group presented more ă than 1 risk factor, the most prevalent ones being Lp(a) > 50 mg/dL and ă smoking. Patients in the VHR group were older (50.6 vs 45.0 years old, P ă =.0002), and presented a higher body mass index (25.5 kg/m(2) vs 23.3 ă kg/m(2), P <.0001). The proportion of patients with carotid arterial ă plaque was higher in the VHR group (59.8% vs 48.6%, P =.06). Total ă cholesterol (2.41 g/L on average) and LDL-C (1.65 g/L on average) were ă not found to be significantly different. Maximum level of lipid-lowering ă treatments were used in 34% of cases in the VHR group, significantly ă higher than 16% in the high-risk group (P =.001). Very similar results ă were found when using the National Lipid Association recommendations. ă CONCLUSION: This study provides a detailed description of French heFH ă patients according to their CV risk. Patients with very high CV risk had ă usually more advanced carotid plaques and were treated with heavier ă lipid-lowering drugs although their LDL-C level remained similar. This ă highlights the significant burden of this population. (C) 2016 National ă Lipid Association. All rights reserved.
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