Long-term LDL-c lowering in heterozygous familial hypercholesterolemia normalizes carotid intima-media thickness

Sivapalaratnam, S.; van Loendersloot, L.L.; Hutten, B.A.; Kastelein, J.J.P.; Trip, M.D.; de Groot, E.

doi:10.1016/j.atherosclerosis.2010.06.040

« Previous Next »Atherosclerosis
Volume 212, Issue 2 , Pages 571-574, October 2010

Long-term LDL-c lowering in heterozygous familial hypercholesterolemia normalizes carotid intima-media thickness

S. Sivapalaratnam
- Department of Vascular Medicine, Academic Medical Centre, F4-159.2, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- These authors contributed equally to the manuscript.
- Corresponding author. Tel.: +31 20 566 6396; fax: +31 20 5669343.
L.L. van Loendersloot
- Department of Vascular Medicine, Academic Medical Centre, F4-159.2, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands
- These authors contributed equally to the manuscript.
B.A. Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
J.J.P. Kastelein
- Department of Vascular Medicine, Academic Medical Centre, F4-159.2, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
M.D. Trip
- Department of Vascular Medicine, Academic Medical Centre, F4-159.2, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
E. de Groot
- Department of Vascular Medicine, Academic Medical Centre, F4-159.2, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Received 9 March 2010; received in revised form 21 June 2010; accepted 24 June 2010. published online 23 July 2010.

Abstract

Objective

We investigated the effectiveness of statins in daily practice in reducing the arterial wall thicknesses by comparing the carotid intima-media thickness (cIMT) between statin-treated familial hypercholesterolemia (FH) patients and their unaffected spouses.

Methods

FH subjects treated with LDL-c lowering medication for at least 5 years and their unaffected spouses were included in this observational study. Clinical data and carotid intima-media thickness (cIMT) as surrogate marker for atherosclerosis were acquired.

Results

In total 40 FH patients, age 48.4±4.2 years, and their 40 unaffected spouses, age 47.4±3.9 years, were included. Pre-treatment total cholesterol levels of FH patients were on average 9.3±2.0mmol/L. Treated FH patients and unaffected spouses exhibited similar LDL-c (3.8±1.5 vs. 3.5±1.1mmol/L; p=0.25) and total cholesterol levels (5.8±1.6 vs. 5.6±1.1mmol/L; p=0.56). Also, in a multivariate model cIMT adjusted for age and sex did not differ between affecteds and spouses (95% CI: −0.032 to 0.092mm; p=0.34).

Conclusion

Long-term statin treatment normalizes cIMT in severe FH patients and therefore it is likely that the extreme risk of cardiovascular disease in FH patients is significantly reduced by this therapy.

Keywords: FH, cIMT, Atherosclerosis, Long-term treatment