Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Atherosclerosis. 2023 Apr;371:61-66. doi: 10.1016/j.atherosclerosis.2023.03.005. Epub 2023 Mar 17.
No previous study has investigated the association between attainment of low-density lipoprotein (LDL) cholesterol treatment target and better prognosis in patients with familial hypercholesterolemia (FH). The current research aimed to examine the association between attainment of LDL cholesterol treatment target and major adverse cardiac events (MACEs) in patients with FH to validate the current LDL cholesterol treatment targets in primary (<100 mg/dL) and secondary (<70 mg/dL) prevention settings.
The data of patients with FH who were admitted to Kanazawa University Hospital between 2000 and 2020 and who were followed-up were retrospectively reviewed. The number of MACEs, including mortality associated with cardiovascular disease, unstable angina, and myocardial infarction per 1000 person-years, was calculated for each stratum for the attainment of LDL cholesterol target.
The median follow-up duration was 12.6 years. In total, 132 MACEs were recorded during the follow-up period. The numbers of patients who attained the LDL cholesterol target in the primary and secondary prevention groups were 228 (31.9%) and 40 (11.9%), respectively. The event rates per 1000 person-years for LDL cholesterol levels of <100 and ≥100 mg/dL in the primary prevention group were 2.6 and 4.4, respectively. The event rates per 1000 person-years for LDL cholesterol levels of <70 and ≥70 mg/dL in the secondary prevention group were 15.3 and 27.5, respectively.
Attainment of the LDL cholesterol target is associated with better prognosis in patients with FH. However, the attainment rate is currently inadequate among Japanese.
既往研究尚未探讨家族性高胆固醇血症（FH）患者达到低密度脂蛋白（LDL）胆固醇治疗目标与预后改善之间的关系。本研究旨在检验 FH 患者达到 LDL 胆固醇治疗目标与主要不良心脏事件（MACEs）之间的相关性，以验证目前 LDL 胆固醇治疗在一级（<100mg/dL）和二级（<70mg/dL）预防中的目标。
回顾性分析了 2000 年至 2020 年期间在金泽大学医院就诊并接受随访的 FH 患者的数据。计算了每个 LDL 胆固醇目标达标分层中每 1000 人年的 MACE 发生率（包括心血管疾病相关死亡率、不稳定型心绞痛和心肌梗死）。
中位随访时间为 12.6 年。随访期间共记录了 132 例 MACE。在一级和二级预防组中，达到 LDL 胆固醇目标的患者分别为 228 例（31.9%）和 40 例（11.9%）。一级预防组中 LDL 胆固醇水平<100mg/dL 和≥100mg/dL 的事件发生率分别为每 1000 人年 2.6 和 4.4。二级预防组中 LDL 胆固醇水平<70mg/dL 和≥70mg/dL 的事件发生率分别为每 1000 人年 15.3 和 27.5。
在 FH 患者中，达到 LDL 胆固醇目标与预后改善相关。然而，目前日本的达标率不足。
