Efficiency and problems of statin therapy in patients with heterozygous familial hypercholesterolemia

Korneva, Viktoria; Kuznetsova, T.; Julius, Ulrich

doi:10.1016/j.atherosclerosissup.2019.08.029

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…In another previous cohort study published by Besseling et al hypertension was found in only 11% of FH patients ( Besseling et al, 2014 ). We found surprisingly high prevalence of smoking (66.4%), which was similar to that of the Polish FH population mentioned above (59.2, 61.7 and 50.7% in definite, probable and possible FH, respectively) ( Dyrbuś et al, 2019 ), but only 29.5% in the Romanian ( Vlad et al, 2021 ), 16.8% in the Karelian ( Korneva et al, 2019 ) and 16.7% in the Mexican FH populations ( Mehta et al, 2021 ). In a Turkish FH registry, 12.5% of FH patients were smokers, while this number was found to be 20.2% in males according to an Italian FH registry ( Bertolini et al, 2013 ; Kayikcioglu et al, 2018 ).…”

Section: Discussionsupporting

confidence: 86%

“…Dyrbus et al also reported increased prevalence of arterial hypertension in Polish patients with definite, probable and possible FH (69.4, 70.7 and 72.6%, respectively) ( Dyrbuś et al, 2019 ). Korneva detected a 59.2% hypertension prevalence in FH patients from Karelia ( Korneva et al, 2019 ). However, Vlad et al found only a 50.8% prevalence of hypertension in a Romanian FH patient population ( Vlad et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Associations Between Serum Lipoprotein (a) Levels and Atherosclerotic Vascular Diseases in Hungarian Patients With Familial Hypercholesterolemia Using Data Mining and Machine Learning

et al. 2022

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Background and aims: Premature mortality due to atherosclerotic vascular disease is very high in Hungary in comparison with international prevalence rates, though the estimated prevalence of familial hypercholesterolemia (FH) is in line with the data of other European countries. Previous studies have shown that high lipoprotein(a)- Lp(a) levels are associated with an increased risk of atherosclerotic vascular diseases in patients with FH. We aimed to assess the associations of serum Lp(a) levels and such vascular diseases in FH using data mining methods and machine learning techniques in the Northern Great Plain region of Hungary.Methods: Medical records of 590,500 patients were included in our study. Based on the data from previously diagnosed FH patients using the Dutch Lipid Clinic Network scores (≥7 was evaluated as probable or definite FH), we trained machine learning models to identify FH patients.Results: We identified 459 patients with FH and 221 of them had data available on Lp(a). Patients with FH had significantly higher Lp(a) levels compared to non-FH subjects [236 (92.5; 698.5) vs. 167 (80.2; 431.5) mg/L, p < .01]. Also 35.3% of FH patients had Lp(a) levels >500 mg/L. Atherosclerotic complications were significantly more frequent in FH patients compared to patients without FH (46.6 vs. 13.9%). However, contrary to several other previous studies, we could not find significant associations between serum Lp(a) levels and atherosclerotic vascular diseases in the studied Hungarian FH patient group.Conclusion: The extremely high burden of vascular disease is mainly explained by the unhealthy lifestyle of our patients (i.e., high prevalence of smoking, unhealthy diet and physical inactivity resulting in obesity and hypertension). The lack of associations between serum Lp(a) levels and atherosclerotic vascular diseases in Hungarian FH patients may be due to the high prevalence of these risk factors, that mask the deleterious effect of Lp(a).

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Assessment of Associations Between Serum Lipoprotein (a) Levels and Atherosclerotic Vascular Diseases in Hungarian Patients With Familial Hypercholesterolemia Using Data Mining and Machine Learning

et al. 2022

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“…This is consistent with findings from the survey of FH patients in UK lipid clinics, which showed that more men than women attained the FH treatment target of 50% or more reduction in baseline LDL-C [14]. In addition, gender was not found to be associated with adherence to statin therapy in a study of patients with FH [26].…”

Section: Comparison With Existing Literaturesupporting

confidence: 88%

Sex differences in cardiovascular morbidity associated with familial hypercholesterolaemia: A retrospective cohort study of the UK Simon Broome register linked to national hospital records

et al. 2020

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Background and aims: The UK Simon Broome (SB) familial hypercholesterolaemia (FH) register previously reported 3-fold higher standardised mortality ratio for cardiovascular disease (CVD) in women compared to men from 2009 to 2015. Here we examined sex differences in CVD morbidity in FH by national linkage of the SB register with Hospital Episode Statistics (HES). Methods: Of 3553 FH individuals in the SB register (aged 20-79 years at registration), 2988 (52.5% women) had linked HES records. Standardised Morbidity Ratios (SMbR) compared to an age and sex-matched UK general practice population were calculated [95% confidence intervals] for first CVD hospitalisation in HES (a composite of coronary heart disease (CHD), myocardial infarction (MI), stable or unstable angina, stroke, TIA, peripheral vascular disease (PVD), heart failure, coronary revascularisation interventions). Results: At registration, men had significantly (p < 0.001) higher prevalence of previous CHD (24.8% vs 17.6%), previous MI (13.2% vs 6.3%), and were commenced on lipid-lowering treatment at a younger age than women (37.5 years vs 42.3 years). The SMbR for composite CVD was 6.83 (6.33-7.37) in men and 7.55 (6.99-8.15) in women. In individuals aged 30-50 years, SMbR in women was 50% higher than in men (15.

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“…Statin therapy has prescribed and evidence-based lipid-lowering drug for lowering LDLc but in higher doses, is associated with an increased risk of hepatic and muscular side effects (as discussed in Section 3.1 ). A subset of patients on statins cannot achieve target plasma cholesterol levels even at the highest doses and decide to stop treatment altogether than deal with the side effects [ 115 ]. Co-therapy involving a statin in combination with a probiotic is another interesting avenue to explore that can exert a combine cholesterol-lowering effect thereby decreasing statin doses [ 116 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Gut Microbiota on Cholesterol Metabolism in Atherosclerosis

Vourakis

Mayer

Rousseau

2021

IJMS

107

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Hypercholesterolemia plays a causal role in the development of atherosclerosis and is one of the main risk factors for cardiovascular disease (CVD), the leading cause of death worldwide especially in developed countries. Current data show that the role of microbiota extends beyond digestion by being implicated in several metabolic and inflammatory processes linked to several diseases including CVD. Studies have reported associations between bacterial metabolites and hypercholesterolemia. However, such associations remain poorly investigated and characterized. In this review, the mechanisms of microbial derived metabolites such as primary and secondary bile acids (BAs), trimethylamine N-oxide (TMAO), and short-chain fatty acids (SCFAs) will be explored in the context of cholesterol metabolism. These metabolites play critical roles in maintaining cardiovascular health and if dysregulated can potentially contribute to CVD. They can be modulated via nutritional and pharmacological interventions such as statins, prebiotics, and probiotics. However, the mechanisms behind these interactions also remain unclear, and mechanistic insights into their impact will be provided. Therefore, the objectives of this paper are to present current knowledge on potential mechanisms whereby microbial metabolites regulate cholesterol homeostasis and to discuss the feasibility of modulating intestinal microbes and metabolites as a novel therapeutic for hypercholesterolemia.

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Efficiency and problems of statin therapy in patients with heterozygous familial hypercholesterolemia

Cited by 9 publications

References 29 publications

Assessment of Associations Between Serum Lipoprotein (a) Levels and Atherosclerotic Vascular Diseases in Hungarian Patients With Familial Hypercholesterolemia Using Data Mining and Machine Learning

Assessment of Associations Between Serum Lipoprotein (a) Levels and Atherosclerotic Vascular Diseases in Hungarian Patients With Familial Hypercholesterolemia Using Data Mining and Machine Learning

Sex differences in cardiovascular morbidity associated with familial hypercholesterolaemia: A retrospective cohort study of the UK Simon Broome register linked to national hospital records

The Role of Gut Microbiota on Cholesterol Metabolism in Atherosclerosis

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