Defining Patients at Extremely High Risk for Coronary Artery Disease in Heterozygous Familial Hypercholesterolemia
Defining Patients at Extremely High Risk for Coronary Artery Disease in Heterozygous Familial Hypercholesterolemia
复制标题
DOI：
10.5551/jat.11536
复制
发表时间：
2012-01-01
影响因子：
4.4
通讯作者：
Harada-Shiba, Mariko
中科院分区：
文献类型：
--
作者：
Sugisawa, Takako;Okamura, Tomonori;Harada-Shiba, Mariko
目的：家族性高胆固醇血症（FH）的杂合子患者与冠状动脉疾病（CAD）的高风险相关，这是其临床结局的主要决定因素。杂合子FH患者的预后差异很大，这取决于他们的CAD风险水平，他们的治疗方案应个体化。我们评估了低密度脂蛋白胆固醇（LDL-C）和跟腱厚度（ATT）的临界水平，以确定杂合子FH患者在“非常高”的风险为CAD.Methods：109杂合子FH患者没有CAD的历史，并有他们的血脂谱和ATT治疗前进行了评估，直到他们的第一次CAD事件或2010年12月31日进行了随访。采用多因素Logistic回归模型分析LDL-C和/或ATT水平与发生CAD风险的相关性。结果：在随访期间，109例患者中有21例发生CAD事件，经冠状动脉造影确诊。LDL-C最高三分位数的个体的CAD风险是最低三分位数的8.29倍。ATT组中最高三分位数的个体的CAD风险比最低三分位数的个体高7.82倍。LDL-C >= 260 mg/dL或ATT >= 14.5的患者CAD风险是LDL-C患者的23.94倍
Aim: Heterozygous patients with familial hypercholesterolemia (FH) are known to be associated with a high risk of coronary artery disease (CAD), which is a major determinant of their clinical outcome. The prognosis of heterozygous FH patients substantially varies, being dependent on the level of their CAD risk, and their therapeutic regimen should be individualized. We assessed critical levels of LDL-cholesterol (LDL-C) and Achilles tendon thickness (ATT) to identify heterozygous FH patients at "very high" risk for CAD.Methods: One hundred and nine heterozygous FH patients who had no history of CAD and had had their plasma lipid profile and ATT assessed before treatment were followed up until their first CAD event or 31 December 2010. Multivariable logistic regression models were used to analyze the correlation of LDL-C and/or ATT levels with the risk of developing CAD.Results: During the follow-up period, 21 of the 109 patients had a CAD event, diagnosed by coronary angiogram. Individuals in the highest tertile of LDL-C had a CAD risk 8.29-fold higher than those in the lowest tertile. Individuals in the highest tertile of the ATT group had a 7.82-fold higher CAD risk than those in the lowest tertile. Those who had either LDL-C >= 260 mg/dL or ATT >= 14.5 had a 23.94-fold higher CAD risk than those with LDL-C