Highlights
- •The Latvian Registry identified 2.3% of FH patients within three years.
- •Patients were poorly managed before inclusion in the Registry.
- •Only 4.4% of patients had their LDL-C levels at goal before inclusion.
- •Specialized care provided by the Registry substantially improved patient management.
Abstract
Background and aims
Familial hypercholesterolemia (FH) was rarely diagnosed in Latvia before 2015, when
the Latvian Registry of FH (LRFH) was established. Here, we report the first experience
of the LRFH over three years (2015–2017).
Methods
The LRFH is an ongoing nationwide, dynamic, long-term prospective cohort. The diagnosis
of FH was assessed using the Dutch Lipid Clinic Network (DLCN) criteria. Cascade screening of first-degree relatives using age- and sex-specific
percentiles of low-density lipoprotein cholesterol (LDL-C) was performed in relatives
of patients with definite and probable FH.
Results
Among the 416 individuals included in the LRFH, 181 patients were diagnosed with FH
(140 index cases and 41 relatives) and 151 with possible FH (not analysed in this
report). The mean age was 51.3 ± 14.1 years, 38.1% (n = 69) were men and 35.4% (n = 64)
had a history of premature coronary heart disease. Only 54.1% (n = 98) of patients
were on any lipid-lowering therapy before inclusion in the LRFH. The maximal statin
dose was used by 23.2% (n = 42), and only 4.4% (n = 8) had their LDL-C levels below
the goal. The initial mean total and LDL-C levels were 7.7 ± 2.2 and 5.5 ± 2.1 mmol/L,
respectively. In a subgroup of patients (n = 49) with follow-up, LDL-C levels were
reduced from 6.1 ± 2.1 to 3.6 ± 1.7 mmol/L (p < 0.001).
Conclusions
An estimated 2.3% of FH patients in Latvia were diagnosed within three years. The
vast majority of FH patients were under-recognized and poorly treated before their
inclusion in the LRFH. Specialized care of FH patients within the frames of the registry
substantially improved the management of this high-risk group.
Keywords
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Article info
Publication history
Accepted:
June 7,
2018
Received in revised form:
May 17,
2018
Received:
March 23,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
