Zhang H W, Li S, Guo Y L, Zhu C G, Wu N Q, Liu G, Dong Q, Sun J, Li J J
Division of Dyslipidemia, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Feb 24;46(2):104-108. doi: 10.3760/cma.j.issn.0253-3758.2018.02.007.
To investigate the prevalence rate and clinical characteristics of familial hypercholesterolemia (FH) in Chinese patients undergoing coronary angiography due to angina-like chest pain. From March 2011 to December 2016, a total of 9 908 consecutive patients undergoing coronary angiography in Fuwai Hospital due to angina-like chest pain were enrolled. The age of enrolled patients was (56.6±11.1) years old, and 6 782 cases (68.4%) were male. The patients were divided into two groups: FH group (271) and non-FH group (9 637) according to the Dutch Lipid Clinic Network diagnostic criteria. A retrospective analyze was performed on the baseline features between the two groups including lipids levels, coronary artery disease (CAD) characteristics, and lipids-lowering treatments. In the total cohort, the prevalence of definite/probable FH was 2.7% (271/9 908). The incidence of premature coronary artery disease (PCAD) (women 60 years old, or men 55 years old) was higher in patients with FH than that in patients without FH (70.2%(201/271) vs. 44.5% (4 287/9 637); χ(2)=93.738, 0.001). Patients with FH had higher level of TC and LDL-C when compared with patients without FH ((6.74±2.48) mmol/L vs. (4.15±1.10) mmol/L; (4.53±2.39) mmol/L vs. (2.52±0.97) mmol/L; =19.403, 22.233, 0.001, respectively). Additionally, 84.9% (230/271) of FH patients were treated with statin at different intensities, but none of them achieved the LDL-C<2.6 mmol/L. Chinese patients with familial hypercholesterolemia not only showed a high presence of PCAD and higher lipids levels, but also exhibited a low rate of achievement of low-density lipoprotein cholesterol targets despite statin therapy. Our results thus highlight the importance of early diagnosis and intensive treatment of FH patients.
为调查因心绞痛样胸痛接受冠状动脉造影的中国患者中家族性高胆固醇血症（FH）的患病率及临床特征。2011年3月至2016年12月，共有9908例因心绞痛样胸痛在阜外医院连续接受冠状动脉造影的患者入组。入组患者年龄为（56.6±11.1）岁，男性6782例（68.4%）。根据荷兰脂质诊所网络诊断标准，将患者分为两组：FH组（271例）和非FH组（9637例）。对两组患者的基线特征进行回顾性分析，包括血脂水平、冠状动脉疾病（CAD）特征及降脂治疗情况。在整个队列中，确诊/疑似FH的患病率为2.7%（271/9908）。FH患者中早发性冠状动脉疾病（PCAD）（女性<60岁，男性<55岁）的发生率高于非FH患者（70.2%（201/271）对44.5%（4287/9637）；χ²=93.738，P<0.001）。与非FH患者相比，FH患者的总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平更高（（6.74±2.48）mmol/L对（4.15±1.1）mmol/L；（4.53±2.39）mmol/L对（2.52±0.97）mmol/L；P分别为19.403、22.233，P<0.001）。此外，84.9%（230/271）的FH患者接受了不同强度的他汀类药物治疗，但无一例LDL-C<2.6 mmol/L。中国家族性高胆固醇血症患者不仅早发性冠状动脉疾病发生率高、血脂水平高，而且尽管接受了他汀类药物治疗，低密度脂蛋白胆固醇达标率仍低。因此，我们的结果凸显了FH患者早期诊断和强化治疗的重要性。
