Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman; Gulf Health Research, Muscat, Oman.
J Clin Lipidol. 2018 May-Jun;12(3):685-692.e2. doi: 10.1016/j.jacl.2018.02.003. Epub 2018 Feb 14.
Information on the epidemiology of familial hypercholesterolemia (FH) in the Arabian Gulf region, which has an elevated rate of consanguinity and type II diabetes, is scarce.
To assess the prevalence of FH, its management, and impact on atherosclerotic cardiovascular disease (ASCVD) outcomes in a multicenter cohort of Arabian Gulf patients with acute coronary syndrome (ACS).
Patients (N = 3224) hospitalized with ACS were studied. FH was diagnosed using the Dutch Lipid Clinic Network criteria. A composite endpoint of nonfatal myocardial infarction, stroke, transient ischemic attack, and mortality between the "probable/definite" and the "unlikely" FH patients was assessed after 1 year. Analyses were performed using univariate and multivariate statistical techniques.
At admission, the proportion of "probable/definite", "possible", and "unlikely" FH in ACS patients was 3.7% (n = 119), 28% (n = 911), and 68% (n = 2194), respectively. Overall, 54% (n = 1730) of patients had diabetes, whereas 24% (n = 783) were current smokers. The "probable/definite" FH group was younger (50 vs 63 years; P < .001), had a greater prevalence of early coronary disease (38% vs 8.8%; P < .001), and previous statin use (87% vs 57%; P < .001) when compared with the "unlikely" FH group. After 1 year, the "probable/definite" FH cohort had worse lipid control (13% vs 23%; P < .001) and presented with a greater association with the composite ASCVD endpoint when compared with the "unlikely" FH group (odds ratio: 1.85; 95% confidence interval: 1.01-3.38; P = .047) after multivariable adjustment.
In Arabian Gulf citizens, FH was common in ACS patients, was undertreated, and was associated with a worse 1-year prognosis.
在阿拉伯海湾地区，近亲结婚和 2 型糖尿病的发病率很高，但有关家族性高胆固醇血症（FH）的流行病学信息却很少。
评估多中心阿拉伯海湾急性冠状动脉综合征（ACS）患者中 FH 的患病率、管理情况及其对动脉粥样硬化性心血管疾病（ASCVD）结局的影响。
研究了因 ACS 住院的患者（N=3224）。使用荷兰血脂诊所网络标准诊断 FH。在 1 年后，评估“可能/确定”和“不太可能”FH 患者之间非致命性心肌梗死、卒中和短暂性脑缺血发作以及死亡率的复合终点。使用单变量和多变量统计技术进行分析。
入院时，ACS 患者中“可能/确定”、“可能”和“不太可能”FH 的比例分别为 3.7%（n=119）、28%（n=911）和 68%（n=2194）。总体而言，54%（n=1730）的患者患有糖尿病，24%（n=783）的患者为当前吸烟者。“可能/确定”FH 组更年轻（50 岁 vs 63 岁；P<.001），更早出现冠状动脉疾病（38% vs 8.8%；P<.001），且更早使用他汀类药物（87% vs 57%；P<.001）。与“不太可能”FH 组相比，1 年后，“可能/确定”FH 组的血脂控制更差（13% vs 23%；P<.001），且与 ASCVD 复合终点的相关性更大（比值比：1.85；95%置信区间：1.01-3.38；P=.047），经多变量调整后。
在阿拉伯海湾居民中，FH 在 ACS 患者中很常见，但治疗不足，且与 1 年预后较差相关。
