Impact of age on excess risk of coronary heart disease in patients with familial hypercholesterolaemia

Abstract

ObjectiveThe primary objective was to study the risk of acute myocardial infarction (AMI) and coronary heart disease (CHD) in patients with familial hypercholesterolaemia (FH) and compare with the risk in the general population.MethodsPatients with an FH mutation but without prior AMI (n=3071) and without prior CHD (n=2795) were included in the study sample during 2001–2009. We obtained data on all AMI and CHD hospitalisations in Norway. We defined incident cases as first time hospitalisation or out-of-hospital death due to AMI or CHD. We estimated standardised incidence ratios (SIRs) with 95% CIs with indirect standardisation using incidence rates for the total Norwegian population stratified by sex, calendar year and 1 year age groups as reference rates.ResultsSIRs for AMI (95% CIs) were highest in the age group 25–39 years; 7.5 (3.7 to 14.9) in men and 13.6 (5.1 to 36.2) in women and decreased with age to 0.9 (0.4 to 2.1) in men and 1.8 (0.9 to 3.7) in women aged 70–79 years. Similarly, SIRs for CHD were highest among patients 25–39 years old; 11.1 (7.1–17.5) in men and 17.3 (9.6–31.2) in women and decreased 2.4 (1.4–4.2) in men and 3.2 (1.5–7.2) in women at age 70–79. For all age groups, combined SIRs for CHD were 4.2 (3.6–5.0) in men and 4.7 (3.9–5.7) in women.ConclusionPatients with FH are at severely increased risk of AMI and CHD compared with the general population. The highest excess risk was in the youngest group aged 25–39 years, in both sexes.

Risk of cardiovascular disease outcomes in primary care subjects with familial hypercholesterolaemia: A cohort study

“…These studies did not, however, evaluate the risk of PVD or TIA and stroke as separate entities. A more recent cohort study of FH registry patients in Norway also found an increased risk of CHD in subjects with genetically diagnosed FH, compared to the general population [22]. Similar to other registry-based researches [5,6], the excess CHD risk was highest in the youngest age group with an increase in the relative risk of fatal and non-fatal CHD before the age of 40 years, which decreases with increasing age [5,6,22].…”

“…A more recent cohort study of FH registry patients in Norway also found an increased risk of CHD in subjects with genetically diagnosed FH, compared to the general population [22]. Similar to other registry-based researches [5,6], the excess CHD risk was highest in the youngest age group with an increase in the relative risk of fatal and non-fatal CHD before the age of 40 years, which decreases with increasing age [5,6,22]. Previous research has shown that the risk of a fatal coronary event associated with FH is greatest in the 20-39 year age group [23].…”

Derivation and validation of SIDIAP-FHP score: A new risk model predicting cardiovascular disease in familial hypercholesterolemia phenotype

“…Although data provided by specialized clinical settings are highly informative, in real life the detection and management of patients with FH may differ. Recent population-based studies show a higher prevalence of FH than those performed in specialized centers [10][11][12][13][14] and describe different characteristics and prognosis in patients with FH [3,[15][16][17]. Therefore, risk functions to predict cardiovascular complications in community-based cohorts of patients with FH would make a valuable complementary tool.…”

Association of familial combined hyperlipidemia with acute coronary syndrome

“…FCHL se odlikuje tendencijom pojavljivanja koronarne bolesti pre 60. godine 9 , s to z ivotna dob od 47 godina u vreme nastanka akutnog infarkta miokarda prikazanog pacijenta i potvrđuje. Izvesna istraz ivanja ukazuju da pacijenti sa FC L imaju jako povec an rizik od akutnog infarkta miokrada i koronarne bolesti www.tmg.org.rs srca u poređenju sa ops tom populacijom, pri c emu je najvec i rizik u z ivotnoj dobi od 25 do 39 godina, kod oba pola [20]. Kada je koronarna bolest srca u dužem periodu klinički nemanifestna, kao što je to bio slučaj kod prikazanog pacijenta, od značaja je blagovremena dijagnostika i tretman dislipidemije.…”