Highlights
- •15.4% of patients with heterozygous FH achieved LDL-C goal attainment
- •High intensity lipid-lowering therapy was used by 54.6% patients
- •The longer the care by a specialist, the higher the probability of LDL-C goal attainment
Abstract
Background and aims
Despite the high prevalence of familial hypercholesterolemia (FH) and available effective
lipid-lowering therapy, most of the individuals with this disorder remain undiagnosed
and undertreated. The aim of the PLANET registry was to assess the real-life attainment
of low-density lipoprotein cholesterol (LDL-C) therapeutic target level in patients
with heterozygous FH, to characterize prescribed lipid-lowering therapy with assessment
of its efficiency according to the attainment of the target LDL-C level, and to characterize
cardiovascular events observed in this patient population again in relation to LDL-C
target level attainment.
Methods
PLANET registry was designed as a non-interventional, retrospective, cross-sectional,
multicentre disease registry for adult patients with heterozygous FH in the Czech
Republic and Slovakia.
Results
Overall, 1755 patients were enrolled at 32 sites specialized in FH treatment. 15.4%
of patients attained the target LDL-C value. The proportion of patients with LDL-C
goal achievement increased to 17.3% in the subgroup of patients receiving high-intensity
statin therapy (54.6% of study population). Out of 55 patients receiving inhibitors
of proprotein convertase subtilisin/kexin type 9 (PCSK9), 61.8% reached the LDL-C
treatment goal. Of all cardiovascular events reported, 14.0% occurred in patients
attaining the LDL-C goal, while it was 86.0% in the not-at-target group. It was documented
(p=0.004) that the longer is the patient in care at the specialized FH centre, the higher
is the probability that he/she will attain the target LDL-C level.
Conclusions
Although target LDL-C level attainment remains relatively low, the likelihood of LDL-C
goal attainment increases with duration of specialized care.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to AtherosclerosisAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Preventing early cardiovascular death in patients with familial hypercholesterolemia.J. Am. Osteopath. Assoc. 2014; 114: 99-108https://doi.org/10.7556/jaoa.2014.023
- Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society.Eur. Heart J. 2013; 34: 3478-3490a
- Human Genetics Programme.1998 (Familial hypercholesterolaemia (FH). Available from:)http://www.who.int/iris/handle/10665/64162Date accessed: May 23, 2017
- Attainment of LDL-cholesterol treatment goals in patients with familial hypercholesterolemia: 5 - year SAFEHEART Registry follow-up.J. Am. Coll. Cardiol. 2016; 67: 1278-1285
- Evaluation of cholesterol lowering treatment of patients with familial hypercholesterolemia: a large cross-sectional study in The Netherlands.Atherosclerosis. 2010; 209: 189-194
http://www.medped.org (Accessed 23 May 2017).
- Lipid levels and their genetic regulation in patients with familial hypercholesterolemia and familial defective apolipoprotein B-100: the MEDPED Slovakia Project.Atheroscler Suppl. Nov. 2003; 4: 3-5
- Slovak MED PED FH group. Familial defective apolipoprotein B-100 in Slovakia: are differences in prevalence of familial defective apolipoprotein B-100 explained by ethnicity?.Atherosclerosis. 2007; 194: e95-107
- Familial hypercholesterolemia in the Czech Republic: more than 17 years of systematic screening within the MedPed project.Physiol. Res. 2017; 66: S1-S9
- ESC/EAS guidelines for the management of dyslipidaemias the task force for the management of dyslipidaemias of the European society of cardiology (ESC) and the European atherosclerosis society (EAS).Atherosclerosis. 2011; 217 (Jul): 3-46
- Guidelines for good pharmacoepidemiology practices (GPP).Pharmacoepidemiol. Drug Saf. 2008; 17: 200-208https://doi.org/10.1002/pds.1471
- Good Epidemiological Practice: IEA Guidelines for Proper Conduct of Epidemiological Research.2007
- ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.J. Am. Coll. Cardiol. 2013; 63: 2889-2934https://doi.org/10.1016/j.jacc.2013.11.002
- Mutations causative of familial hypercholesterolaemia: screening of 98 098 individuals from the Copenhagen General Population Study estimated a prevalence of 1 in 217.Eur. Heart J. 2016; 37: 1384-1394
- Further reduction of low-density lipoprotein cholesterol and C-reactive protein with the addition of ezetimibe to maximum-dose rosuvastatin in patients with severe hypercholesterolemia.J Clin Lipidol. 2007; 1: 280-286
- Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European society of cardiology European action on secondary and primary prevention by intervention to reduce events (EUROASPIRE) IV cross-sectional survey in 14 European regions.Eur J Prev Cardiol. 2016; 18: 2007-2018
- Cholesterol target value attainment and lipid-lowering therapy in patients with stable or acute coronary heart disease: results from the Dyslipidemia International Study II.Atherosclerosis. 2017; 266: 158-166
- Mutational analysis in UK patients with a clinical diagnosis of familial hypercholesterolaemia: relationship with plasma lipid traits, heart disease risk and utility in relative tracing.J. Mol. Med. (Berl.). 2006; 84: 203-214
- Ezetimibe added to statin therapy after acute coronary syndromes.N. Engl. J. Med. 2015; 372: 2387-2397
- ESC/EAS guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the European society of cardiology (ESC) and European atherosclerosis society (EAS) developed with the special contribution of the European assocciation for cardiovascular prevention &rehabilitation (EACPR).Atherosclerosis. 2016; 253: 281-344
- Alirocumab cuts CV events, all-cause death post-ACS.Medscape - Mar. 2018; 10
- Efficacy and safety of evolocumab in reducing lipids and cardiovascular events.N. Engl. J. Med. 2015; 372: 1500-1509
- Risk of fatal coronary heart disease in familial hypercholesterolaemia.BMJ. 1991; 303: 893-896
- Familial hypercholesterolemia in the Danish general population: prevalence, coronary artery disease, and cholesterol-lowering medication.J. Clin. Endocrinol. Metab. 2012; 97: 3956-3964
- Clinical characteristics and evaluation of LDL-cholesterol treatment of the Spanish familial hypercholesterolemia Longitudinal cohort study (SAFEHEART).Lipids Health Dis. 2011; 10: 94
- Cardiovascular risk in patients with familial hypercholesterolemia using optimal lipid-lowering therapy.J Clin Lipidol. 2018; 12 (Mar-Apr): 409-416
- Efficacy and safety of alirocumab in high-risk patients with clinical atherosclerotic cardiovascular disease and/or heterozygous familial hypercholesterolemia (from 5 placebo-controlled ODYSSEY trials).Am. J. Cardiol. 2018; 121: 940-948
- Health disparities among adult patients with a phenotypic diagnosis of familial hypercholesterolemia in the CASCADE-FH™ patient registry.Atherosclerosis. 2017; 267: 19-26
- Attainment of LDL cholesterol treatment goals in children and adolescents with familial hypercholesterolemia. The SAFEHEART follow-up registry.Rev Esp Cardiol. (Engl Ed). Jun. 2017; 70: 444-450
Article info
Publication history
Accepted:
August 17,
2018
Received in revised form:
June 29,
2018
Received:
April 18,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
