Author + information
- Martin Prøven Bogsrud,
- Asgeir Græsdal,
- Dan Johansen,
- Gisle Langslet,
- Anders Hovland and
- Kirsten Holven
Background: LDL-cholesterol (LDL-C) treatment targets for patients with familial hypercholesterolemia (FH) is defined by the European Atherosclerosis Society as LDL-C < 2.5 mmol/L, or < 1.8 mmol/L in very-high-risk FH defined as the presence of coronary heart disease (CHD), coexisting diabetes, or late treatment start (>40 years of age). Conventional lipid-lowering therapy (LLT) includes statins, ezetimibe and resins, but even when these drugs are combined, treatment target might not be achieved. The aim of the study was to investigate FH patients are treated according to the current guidelines, and if treatment with conventional LLT (before the introduction of PCSK9 inhibitors) is sufficient to achieve recommended treatment targets.
Methods: Retrospective collection of data from medical charts of patients with FH followed at lipid clinics in Norway.
Results: All data presented as mean (standard deviation) unless otherwise stated. In total, 714 adult FH patients were included with a follow up of 11.1 (7.9) years at a lipid clinic. Overall, on last follow-up visit, pretreatment total cholesterol was reduced 42% from 9.0 (2.1) to 5.2 (1.5) mmol/L (P<0.001), and pretreatment LDL-C was reduced and 48 % from mean 6.7 (1.9) to 3.4 (1.3) mmol/L (P<0.001). Thirty-four percent of patients were considered very-high-risk FH according to the EAS definition. Compared to normal FH patients, the very-high-risk FH patients more often received maximal statin dose (54 vs. 33%, P<0.001), ezetimibe (76 vs. 48%, P<0.001) or resins (23 vs. 9%, P<0.001), and obtained LDL-C was lower (3.2 vs. 3.5 mmol/L. P<0.001). Only 25% and 8% of patients achieved the LDL-C treatment target of <2.5 mmol/L or <1.8 mmol/L in normal FH and very-high-risk-FH patients, respectively.
Conclusions: Too few patients with FH, and especially among those with very-high-risk FH, achieve LDL-C treatment target on maximal tolerated dose of conventional LLT. New treatment modalities e.g. PCSK9 inhibitor treatment is needed to improve treatment target attainment.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-061
- 2017 American College of Cardiology Foundation