Evaluation of Cardiovascular Risk Factors in Patients With Familial Hypercholesterolemia From the North-eastern Area of Romania

Abstract

Background. Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and nontraditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were: (a)to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b)to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents.Methods. This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH (SM score) were included.Results. The 61 subjects with clinical diagnosis of FH (6.2% of all patients examined) recorded a mean age of 48.5±12.5 years, with more female patients than male patients. Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. As far as treatment was concerned, the effective lipid-lowering drugs were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new CV events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them.Conclusions. In patients with suspected FH, the lipid-lowering agents during the follow-up delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.