Cardiology Department, Hospital Clínico San Carlos, IDISSC, Facultad de Medicina, Universidad Complutense, Madrid, Spain (Dr de Isla); Fundación Hipercolesterolemia Familiar, Madrid, Spain (Drs de Isla, Alonso, and Mata).
Fundación Hipercolesterolemia Familiar, Madrid, Spain (Drs de Isla, Alonso, and Mata); Center for Advanced Metabolic Medicine and Nutrition, Santiago, Chile (Dr Alonso).
J Clin Lipidol. 2022 Sep-Oct;16(5):733-736. doi: 10.1016/j.jacl.2022.07.007. Epub 2022 Jul 18.
Defining patients with familial hypercholesterolemia (FH) destined not to develop clinical atherosclerotic cardiovascular disease (ASCVD) has significant implications for precision and discovery medicine. We investigated the predictors of resilience to ASCVD in a cohort of 248 octogenarian patients with FH enrolled in the SAFEHEART study. Median age at the time of analysis was 84.7 years (82.3-88.1) and 83.6 years (81.9-86.4) in the octogenarian resilient FH (OR-FH) and octogenarian controls non-resilient FH (OCNoR-FH) groups, respectively (p=0.073); 92 (80.0%) and 68 (51.1%) patients were female in the first compared with the second group (p<0.001). Multivariate logistic regression showed that a low 10-year score in SAFEHEART-Risk Equation was the only independent predictor of OR-FH. Application of this simple and validated risk equation may potentially be useful for predicting patients ultra-resilient to the ASCVD sequelae of FH who may require less intensive use of healthcare resources.
确定没有发生临床动脉粥样硬化性心血管疾病（ASCVD）的家族性高胆固醇血症（FH）患者，对精准医学和发现医学具有重要意义。我们在 SAFEHEART 研究中调查了 248 名 80 岁以上 FH 患者队列中 ASCVD 恢复力的预测因素。分析时的中位年龄分别为 84.7 岁（82.3-88.1）和 83.6 岁（81.9-86.4），在 80 岁以上 FH 有恢复力（OR-FH）和 80 岁以上 FH 无恢复力（OCNoR-FH）组（p=0.073）；与第二组相比，第一组中 92 名（80.0%）和 68 名（51.1%）患者为女性（p<0.001）。多变量逻辑回归显示，SAFEHEART 风险方程中的低 10 年评分是 OR-FH 的唯一独立预测因子。该简单且经过验证的风险方程的应用，可能有助于预测 FH 患者 ASCVD 后遗症超强恢复力，这些患者可能需要较少的医疗资源。
