Highlights
- •Attainment of the LDL cholesterol target is currently inadequate in FH.
- •Attainment of the LDL cholesterol target is associated with better prognosis in FH.
- •PCSK9 inhibitor is associated with better attainment rate of the LDL cholesterol target.
Abstract
Background and aims
No previous study has investigated the association between attainment of low-density
lipoprotein (LDL) cholesterol treatment target and better prognosis in patients with
familial hypercholesterolemia (FH). The current research aimed to examine the association
between attainment of LDL cholesterol treatment target and major adverse cardiac events
(MACEs) in patients with FH to validate the current LDL cholesterol treatment targets
in primary (<100 mg/dL) and secondary (<70 mg/dL) prevention settings.
Methods
The data of patients with FH who were admitted to Kanazawa University Hospital between
2000 and 2020 and who were followed-up were retrospectively reviewed. The number of
MACEs, including mortality associated with cardiovascular disease, unstable angina,
and myocardial infarction per 1000 person-years, was calculated for each stratum for
the attainment of LDL cholesterol target.
Results
The median follow-up duration was 12.6 years. In total, 132 MACEs were recorded during
the follow-up period. The numbers of patients who attained the LDL cholesterol target
in the primary and secondary prevention groups were 228 (31.9%) and 40 (11.9%), respectively.
The event rates per 1000 person-years for LDL cholesterol levels of <100 and ≥100 mg/dL
in the primary prevention group were 2.6 and 4.4, respectively. The event rates per
1000 person-years for LDL cholesterol levels of <70 and ≥70 mg/dL in the secondary
prevention group were 15.3 and 27.5, respectively.
Conclusions
Attainment of the LDL cholesterol target is associated with better prognosis in patients
with FH. However, the attainment rate is currently inadequate among Japanese.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: March 16, 2023
Accepted:
March 8,
2023
Received in revised form:
January 10,
2023
Received:
November 3,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier B.V. All rights reserved.
