Oh Jaewon, Lee Chan Joo, Kim Doo Il, Rhee Moo-Yong, Lee Byoung-Kwon, Ahn Youngkeun, Cho Byung Ryul, Woo Jeong-Taek, Hur Seung-Ho, Jeong Jin-Ok, Jang Yangsoo, Lee Sang-Hak
Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Cardiology Division, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Clin Cardiol. 2017 Dec;40(12):1291-1296. doi: 10.1002/clc.22826. Epub 2017 Dec 14.
Data on treatment results of lipid-lowering therapy (LLT) in familial hypercholesterolemia (FH) are limited, particularly in Asian patients.
We sought to evaluate the target achievement rate and associated variables in Korean patients with FH after maximal statin-based LLT.
We enrolled 146 patients with heterozygous FH, and 90 patients were finally analyzed. Patients were initially prescribed rosuvastatin 10 mg or atorvastatin 20 mg, and the regimen was adjusted to achieve the low-density lipoprotein cholesterol (LDL-C) target of 100 mg/dL. The primary evaluation point was the achievement rate of the LDL-C targets at 12 months: LDL-C < 100 mg/dL and ≥50% LDL-C reduction. The associations between clinical variables and target achievement were also analyzed.
At 12 months, 58% of patients were receiving high-intensity regimens, whereas 46% were receiving combination therapy. The mean pre- and post-treatment LDL-C levels were 229 and 118 mg/dL, respectively. Twenty-eight percent of patients achieved LDL-C < 100 mg/dL, and 47% achieved ≥50% LDL-C reduction. Pretreatment LDL-C and high-intensity regimens indicated a negative tendency toward the attainment of LDL-C < 100 mg/dL. Conversely, pretreatment LDL-C and diabetes mellitus were positively associated with a higher rate of ≥50% LDL-C reduction.
The target achievement of LDL-C < 100 mg/dL was low, and 50% LDL-C reduction was moderately achieved in Korean patients with FH receiving maximal statin-based LLT. Pretreatment LDL-C levels and diabetes mellitus were associated with target achievement. Our results provide rare and informative data on FH treatment in Asian patients.
关于家族性高胆固醇血症（FH）患者降脂治疗（LLT）结果的数据有限，尤其是在亚洲患者中。
我们试图评估接受最大剂量他汀类药物治疗的韩国FH患者的目标达成率及相关变量。
我们纳入了146例杂合子FH患者，最终对90例患者进行了分析。患者最初被处方瑞舒伐他汀10毫克或阿托伐他汀20毫克，并调整治疗方案以实现低密度脂蛋白胆固醇（LDL-C）目标值100毫克/分升。主要评估点为12个月时LDL-C目标达成率：LDL-C<100毫克/分升且LDL-C降低≥50%。还分析了临床变量与目标达成之间的关联。
在12个月时，58%的患者接受高强度治疗方案，而46%的患者接受联合治疗。治疗前和治疗后LDL-C的平均水平分别为229毫克/分升和118毫克/分升。28%的患者LDL-C<100毫克/分升，47%的患者LDL-C降低≥50%。治疗前LDL-C水平和高强度治疗方案显示出LDL-C<100毫克/分升达标率呈负向趋势。相反，治疗前LDL-C水平和糖尿病与LDL-C降低≥50%的较高达标率呈正相关。
在接受最大剂量他汀类药物治疗的韩国FH患者中，LDL-C<100毫克/分升的目标达成率较低，LDL-C降低50%的目标达成情况一般。治疗前LDL-C水平和糖尿病与目标达成相关。我们的结果为亚洲患者FH治疗提供了罕见且有价值的数据。
