LDL-cholesterol goal achievement, cardiovascular disease, and attributed risk of Lp(a) in a large cohort of predominantly genetically verified familial hypercholesterolemia

Abstract

 714 adult FH subjects followed at a lipid clinic for 11.1 (7.9) years  LDL-C ≤2.5 mmol/L [~100 mg/dL] was achieved in 25% of FH subjects.  LDL-C ≤1.8 mmol/L [~70 mg/dL]) was achieved in 8% of very-high-risk FH subjects.  Prevalence of CHD was doubled in FH subjects with high Lp(a) levels.

Lower risk of smoking-related cancer in individuals with familial hypercholesterolemia compared with controls: a prospective matched cohort study

“…Hence, the reduced risk observed in the FH group is likely caused by less smoking in FH individuals than in controls. Indeed, in 2014–15, 9% of a subsample of the FH population in the present study were current smokers 18 , compared with 13% of the general population 19 and similar differences are supported by others 20 . Furthermore, the SAFEHEART study reported that 2404 adult individuals with FH smoked less than their non-affected siblings 5 .…”

Longitudinal low density lipoprotein cholesterol goal achievement and cardiovascular outcomes among adult patients with familial hypercholesterolemia: The CASCADE FH registry

“…The results of the present analysis of longitudinal data from 1900 adult patients with heterozygous FH in the CASCADE FH Registry confirmed very late diagnosis of FH at age 50 ± 18 years, frequently only after the onset of ASCVD, and low rates of achievement of LDL-C goals during follow-up (only 48% with LDL-C < 100 mg/dl and 22% < 70 mg/dl). Although these rates of LDL-C goal achievement are suboptimal, they are actually much higher than the results from a recent retrospective analysis that showed LDL-C < 100 mg/dl and 70 mg/ dl in only 25% and 8% of FH subjects, respectively, over a mean followup of 11.1 years in specialty lipid clinics [10]. Results in this study are similar to those reported from other longitudinal registries including the SAFEHEART study [6].…”

Regional Variations in Alirocumab Dosing Patterns in Patients with Heterozygous Familial Hypercholesterolemia During an Open-Label Extension Study

“…Patients with HeFH are typically initiated on maximally tolerated statin therapy with or without ezetimibe, but in clinical practice, many patients do not reach their guidelinerecommended LDL-C treatment goals without additional LLTs [4][5][6][14][15][16]. The ODYSSEY OLE study was designed to evaluate the long-term efficacy and safety of alirocumab in patients with HeFH, as well as to investigate physician dosing decisions with the two alirocumab dosages available (75 and 150 mg Q2W), in a comparable setting to real-world clinical practice [12].…”