Wang Yihan, Li Chuang, Zhao Wenshu, Dong Ying, Wang Peijia
School of The Third Clinical Medical College, Capital Medical University, Beijing, People's Republic of China.
Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
BMC Cardiovasc Disord. 2024 Dec 21;24(1):737. doi: 10.1186/s12872-024-04428-3.
Familial hypercholesterolemia (FH) is a genetically inherited disorder caused by monogenic mutations or polygenic deleterious variants. Patients with FH innate with significantly elevated risks for coronary heart disease (CHD). FH prevalence based on genetic testing in Chinese CHD patients is missing. Whether classical index of coronary atherosclerosis severity can be used as indicators of FH needs to be explored. To investigate the FH prevalence in Chinese CHD patients and the association of SYNTAX I score with FH genotype.
The monogenic and polygenic FH related genes were genotyped in 400 consecutively enrolled CHD patients. The clinical characteristics and SYNTAX I scores were analyzed in a retrospective nested case-control study.
The prevalence of genetically confirmed FH in our CHD cohort was 8.75%. The cLDL-C level, SYNTAX I scores and incidences of triple vessel lesions in FH patients were significantly higher, while cLDL-C and SYNTAX I scores were independent risk factors for FH. Furthermore, cLDL-C levels of polygenic FH were significantly lower than monogenic FH, while their severity of coronary atherosclerosis was comparable.
Our study revealed that the SYNTAX I score was an independent risk factor for FH. Besides, polygenic origin of FH should be taken into consideration for CHD patients suspected of FH.
家族性高胆固醇血症(FH)是一种由单基因突变或多基因有害变异引起的遗传性疾病。FH患者患冠心病(CHD)的风险显著升高。中国冠心病患者基于基因检测的FH患病率尚不清楚。冠状动脉粥样硬化严重程度的经典指标是否可作为FH的指标有待探索。旨在调查中国冠心病患者的FH患病率以及SYNTAX I评分与FH基因型的关联。
对400例连续入选的冠心病患者进行单基因和多基因FH相关基因的基因分型。在一项回顾性巢式病例对照研究中分析临床特征和SYNTAX I评分。
我们的冠心病队列中基因确诊的FH患病率为8.75%。FH患者的cLDL-C水平、SYNTAX I评分和三支血管病变发生率显著更高,而cLDL-C和SYNTAX I评分是FH的独立危险因素。此外,多基因FH的cLDL-C水平显著低于单基因FH,但其冠状动脉粥样硬化严重程度相当。
我们的研究表明SYNTAX I评分是FH的独立危险因素。此外,对于疑似FH的冠心病患者,应考虑FH的多基因起源。