Prevalence and pharmacologic management of familial hypercholesterolemia in an unselected contemporary cohort of patients with stable coronary artery disease

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  • OIon behalf of the START Investigators
    on behalf of the START Investigators
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Abstract
Introduction: Familial hypercholesterolemia (FH) is an inherited disorder characterized by elevated plasma levels of low‐density lipoprotein cholesterol (LDL‐C) associated with premature cardiovascular disease.Methods: Using the data from the START (STable Coronary Artery Diseases RegisTry) study, a nationwide, prospective survey on patients with stable coronary artery disease (CAD), we described prevalence and lipid lowering strategies commonly employed in these patients. The study population was divided into “definite/probable FH,” defined as a Dutch Lipid Clinic Network (DLCN) score ≥6, “possible FH” with DLCN 3‐5, and “unlikely FH” in presence of a DLCN P < 0.0001) and a target of ≤70 mg/dL was reached in 10.9%, 30.0%, and 22.0% (P < 0.0001) of patents with definite/probable, possible FH, and unlikely FH, respectively. Statin therapy was prescribed in 85 (92.4%) patients with definite/probable FH, in 38 (95.0%) with possible FH, and in 3621 (92.9%) with unlikely FH (P = 0.86). The association of statin and ezetimibe, in absence of other lipid‐lowering therapy, was more frequently used in patients with definite/probable FH compared to patients without FH (31.5% vs 17.5% vs 9.5%; P < 0.0001).Conclusions: In this large cohort of consecutive patients with stable CAD, FH was highly prevalent and generally undertreated with lipid lowering therapies.

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