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MONDAY, Sept. 23, 2019 (HealthDay News) — Even with care in specialty clinics, low-density lipoprotein cholesterol (LDL-C) persists above target levels in more than half of patients with familial hypercholesterolemia (FH), according to a study published in the October issue of Atherosclerosis<\/i>.<\/p>\n
P. Barton Duell, M.D., from Oregon Health and Science University in Portland, and colleagues used data from the CASCADE FH Registry to assess longitudinal changes in medication usage, LDL-C levels, and the rate of major adverse cardiovascular events (MACE; myocardial infarction, coronary revascularization, stroke, or transient ischemic attack) in 1,900 adults (mean age, 56 years) with FH followed in U.S. specialty clinics.<\/p>\n
The researchers note that 37 percent of patients had atherosclerotic cardiovascular disease (ASCVD) at enrollment, mean pretreatment LDL-C levels were 249 mg\/dL, mean enrollment LDL-C levels were 145 mg\/dL, and 93 percent of patients were taking lipid-lowering therapy. At a median follow-up of 20 months, the investigators found that lipid-lowering therapy use increased (mean decrease in LDL-C, 32 mg\/dL). However, only 48 percent of patients achieved LDL-C <100 mg\/dL and 22 percent achieved LDL-C <70 mg\/dL. There was an association between ASCVD at enrollment and greater likelihood of goal achievement. Among patients with prior ASCVD, MACE rates were almost six times higher versus patients without a history (4.6 versus 0.8\/100 patient-years). Markers of FH severity and conventional ASCVD risk factors were also associated with incident MACE.<\/p>\n
“Earlier and more aggressive therapy of FH is needed to prevent ASCVD events,” the authors write.<\/p>\n
Several authors disclosed financial ties to the pharmaceutical industry.<\/p>\n