scholarly journals How Can We Identify Very High-Risk Heterozygous Familial Hypercholesterolemia?

2022 ◽  
Author(s):  
Yu Kataoka ◽  
Sayaka Funabashi ◽  
Takahito Doi ◽  
Mariko Harada-Shiba
Keyword(s):  
High Risk ◽  
Familial Hypercholesterolemia ◽  
Heterozygous Familial Hypercholesterolemia ◽  
Very High

Defining Patients at Extremely High Risk for Coronary Artery Disease in Heterozygous Familial Hypercholesterolemia

2012 ◽  
Vol 19 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Takako Sugisawa ◽  
Tomonori Okamura ◽  
Hisashi Makino ◽  
Makoto Watanabe ◽  
Ichiro Kishimoto ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Familial Hypercholesterolemia ◽  
Heterozygous Familial Hypercholesterolemia ◽  
Artery Disease

Management of high and very high risk patients with familial hypercholesterolemia: Results from an observational study in Bulgaria

2017 ◽  
Vol 263 ◽  
pp. e38-e39 ◽  
Author(s):  
Ivo Petrov ◽  
Arman Postadzhiyan ◽  
Mariya Tokmakova ◽  
Janet Addison ◽  
Reneta Petkova
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Familial Hypercholesterolemia ◽  
High Risk Patients ◽  
Risk Patients ◽  
Very High

scholarly journals Myocardial perfusion findings evaluated by gated-SPECT in dyslipidemic very high-risk patients

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
A Puente Barragan ◽  
P Olivares Garcia ◽  
MC Martinez Escobar ◽  
R Trujillo Cortes
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Myocardial Perfusion ◽  
Familial Hypercholesterolemia ◽  
Gated Spect ◽  
Therapeutic Option ◽  
Structural Heart Disease ◽  
Complete Information ◽  
Atypical Chest Pain ◽  
Very High

Abstract Funding Acknowledgements Type of funding sources: None. Background. Dyslipidemia is one of the main risk factors for atherosclerotic disease. Timely diagnosis and appropriate treatment are therefore essential in the prevention and recurrence of cardiovascular disease (CVD). The detection of ischemia with myocardial perfusion gated-SPECT is a valuable diagnostic option that provides complete information to select the best therapeutic option, reducing morbidity and mortality in this group of patients. Purpose. To evaluate the findings of myocardial perfusion imaging (MPI) using gated-SPECT in a group of patients with dyslipidemia and very high cardiovascular risk. Methods. We retrospectively evaluated gated-SPECT results of 66 very high-risk dyslipidemic patients with a diagnosis or clinical suspicion of coronary artery disease (CAD). Exclusion criteria: structural heart disease, dilated hypertrophic cardiomyopathy, hemodynamic instability, low-intermediate risk. Rest-stress imaging with gated-SPECT Technetium-99m Sestamibi was acquired on a dedicated cardio gamma camera and subjectively evaluated in a 17-segment analysis. Ischemia was classified as mild, moderate, and severe. Statistical analysis: SPSS system, continuous data were expressed as mean ± SD, percentages were rounded; Chi-square and Student’s t-tests were used. Results. Mean age 61.06 ± 12.87 years old, 40 (61%) were men; 61 (92%) with primary and 5 (8%) with familial hypercholesterolemia. More than 80% have at least one or more cardiovascular (CV) risk factors; 73% have dyslipidemia, diabetes, and arterial hypertension, 52% tabaquism, 36% obesity, 11% kidney disease, and 30% family history of CV disease; all women were post-menopausal (44%). Asymptomatic (56%), 30% with dyspnea or equivalents, 9% atypical chest pain, and 5% typical angina. Gated-SPECT: 56% with ischemia; mild ischemia was present in 33% and 11% of men and women, and moderate in 35% and 27% respectively. Primary hypercholesterolemia: 26 % with mild, 28% moderate, and 46% without ischemia; 80% of familial hypercholesterolemia with moderate and 20% without ischemia. Conclusion. Myocardial ischemia was present in 56% of very high-risk dyslipidemic patients, predominantly in men (67.5%). Although 56% were asymptomatic, ischemia was detected in 54% of the patients with primary and 80% with familial hypercholesterolemia. It is advisable to perform MPI with gated-SPECT for the early detection of ischemia in high-risk dyslipidemic patients, even asymptomatic.

The very high cardiovascular risk in heterozygous familial hypercholesterolemia: Analysis of 734 French patients

2016 ◽  
Vol 10 (5) ◽  
pp. 1129-1136.e3 ◽  
Author(s):  
Sophie Béliard ◽  
Aurélie Millier ◽  
Valérie Carreau ◽  
Alain Carrié ◽  
Philippe Moulin ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Familial Hypercholesterolemia ◽  
High Cardiovascular Risk ◽  
Heterozygous Familial Hypercholesterolemia ◽  
Very High

scholarly journals Adherence to therapeutic guidelines among patients treated with statins. Results from STAR study

2012 ◽  
Vol 13 (1) ◽  
pp. 7-13
Author(s):  
Luca Degli Esposti ◽  
Diego Sangiorgi ◽  
Gabriele Lazzeri ◽  
Stefano Buda
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Familial Hypercholesterolemia ◽  
Lipid Lowering ◽  
Local Health ◽  
Cerebrovascular Event ◽  
First Choice ◽  
Therapeutic Guidelines ◽  
Absolute Cardiovascular Risk ◽  
Very High

INTRODUCTION: the objective of this study was to analyze adherence to therapeutic guidelines among patients treated with lipid lowering drugs (statins).MATERIAL AND METHODS: a retrospective observational study including 5 Local Health Units (LHUs) was conducted using administrative databases. Patients who received at least one prescription for statins between January 1st, 2007 and June 30th, 2008 were selected and followed for 12 months. Patients were classified according to their level of absolute cardiovascular risk (moderate, high, very high according to Nota 13 AIFA).RESULTS: a total of 71,855 patients were included (14,133 newly treated patients with statins, representing 19.4% of total sample), (age 68.8±10.7, male 51%). Level of absolute cardiovascular risk were: moderate risk (45.4%), high risk (33.4%), very high risk (16.3%), familial hypercholesterolemia (4.9%). Statins assumed by patients in analysis were stratified in two groups (first or second choice), accordingly to their efficacy (level of LDL cholesterol reduction) in relation to the patient’s cardiovascular risk (coherently with new Nota 13 AIFA, 2011). Among patients with a very high cardiovascular risk, only 52.8% used statins indicated by Nota13 as a first choice while 2.9% used a second choice statin and 44.3% used an inadequate statin and/or dosage; among familial hypercholesterolemia patients, those percentages were, respectively: 53.8%, 21.1% and 25.1%. When only patients naïve to statins treatment were analyzed, similar percentages were found. Only few patients in very high risk group used adequate dosages: among patients treated with rosuvastatin and atorvastatin, 11.2% used atorvastatin 40 mg, and 0.2% used atorvastatin 80 mg (this population was not analyzed for events because of low numerosity) while 4.1% used rosuvastatin 20 mg and 0.2% used rosuvastatin 40 mg; overall, 84.3% of patients in this group used inadequate dosages. Cardiovascular events at one year of follow up were 1.6% for patients treated with rosuvastatin 20 mg, 1.6% for rosuvastatin 40 mg and 6.1% for atorvastatin 40 mg; death rates (any cause) were 0.9%, 0.0%, 2.6% respectively. The analysis of the sub-population of patients treated with rosuvastatin 20 mg with previous CV event showed a percentage of patients with a CV event during the observational period of 3.4%, a percentage of patients with cerebrovascular event of 0.9% and a mortality percentage of 0.9%.Conclusions: in real practice setting, the percentage of patients prescribed for recommended statins and dosages is low.

Target LDL Under 70 mg/dL for Very High Risk

2012 ◽  
Vol 45 (7) ◽  
pp. 14
Author(s):  
JENNIE SMITH
Keyword(s):  
High Risk ◽  
Very High
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