Drouin-Chartier Jean-Philippe, Tremblay André J, Godbout Dominic, Gagnon Alexandre, Clavel Marie-Annick, Clisson Marine, Arsenault Benoit J, Pibarot Philippe, Larose Éric, Couture Patrick
Nutrition, health and society (NUTRISS) Research Center, Institute on Nutrition and Functional Foods (INAF), Laval University, Québec, Québec, Canada.
Faculty of Pharmacy, Laval University, Québec, Québec, Canada.
CJC Open. 2020 Sep 16;3(1):62-70. doi: 10.1016/j.cjco.2020.09.010. eCollection 2021 Jan.
Determinants of coronary artery calcification (CAC) prevalence and severity in heterozygous familial hypercholesterolemia (HeFH) remain understudied. The objective of this cross-sectional study was to investigate correlates of CAC in patients with HeFH.
A CAC score was calculated by a noncontrast computed tomography scan in women (n = 68) and men (n = 78) with genetically defined HeFH. We classified CAC prevalence and severity using 3 categories: CAC score = 0 Agatston Unit (AU), CAC score = 1-100 AU, and CAC score > 100 AU. Information on potential correlates of CAC including familial and personal health history, cardiovascular risk factors, lipid-lowering medication, and lifestyle habits was collected.
A total of 95 patients had prevalent CAC. Independent correlates of CAC prevalence and severity included age (odds ratio [OR] per 10 years: 5.06, 95% confidence interval [CI]: 3.19, 7.93, < 0.0001), family history of premature cardiovascular disease (OR: 3.88, 95% CI: 1.71, 8.81, = 0.001), male sex (OR: 3.40, 95% CI: 1.49, 7.78, = 0.004), statin use (OR: 15.5, 95% CI: 1.89, 126, = 0.01), diet quality assessed with the Alternative Healthy Eating Index score (OR per 1 standard deviation: 0.59, 95% CI: 0.39, 0.90, = 0.01), ever smoking (OR: 3.06, 95% CI: 1.20, 7.81, = 0.02), receptor-negative genotype (OR: 3.17, 95% CI: 1.16, 8.66, = 0.02), lipoprotein(a) year-score (OR per 1 standard deviation of log-transformed year-score: 1.53, 95% CI: 0.99, 2.36, = 0.05).
In individuals with HeFH, age, family history of premature cardiovascular disease, sex, statin use, diet quality, smoking status, the genotype, and lipoprotein(a) concentrations were independently associated with CAC prevalence and severity.
杂合子家族性高胆固醇血症（HeFH）患者冠状动脉钙化（CAC）的患病率及严重程度的决定因素仍未得到充分研究。这项横断面研究的目的是调查HeFH患者中CAC的相关因素。
对经基因检测确诊为HeFH的68名女性和78名男性进行非增强计算机断层扫描，计算CAC评分。我们将CAC的患病率和严重程度分为3类：CAC评分=0阿加斯顿单位（AU）、CAC评分=1 - 100 AU和CAC评分>100 AU。收集了包括家族和个人健康史、心血管危险因素、降脂药物及生活方式习惯等CAC潜在相关因素的信息。
共有95例患者存在明显的CAC。CAC患病率和严重程度的独立相关因素包括年龄（每10岁的比值比[OR]：5.06，95%置信区间[CI]：3.19，7.93，P<0.0001）、早发性心血管疾病家族史（OR：3.88，95%CI：1.71，8.81，P = 0.001）、男性（OR：3.40，95%CI：1.49，7.78，P = 0.004）、使用他汀类药物（OR：15.5，95%CI：1.89，126，P = 0.01）、用替代健康饮食指数评分评估的饮食质量（每1个标准差的OR：0.59，95%CI：0.39，0.90，P = 0.01）、曾经吸烟（OR：3.06，95%CI：1.20，7.81，P = 0.02）、受体阴性基因型（OR：3.17，95%CI：1.16，8.66，P = 0.02）、脂蛋白(a)年评分（每1个对数转换年评分标准差的OR：1.53，95%CI：0.99，2.36，P = 0.05）。
在HeFH患者中
