Modernising workflows for high throughput testing for Familial Hypercholesterolaemia: How to deliver a cost effective genetic testing service

Honeychurch, J.; Hills, Alison; Dean, P.D.G.; Greenslade, Mark; Buxton, Chris; Woodward, Geoff; Dennis, Glynn; Bayley, G.; Gritzmacher, L.; Haralambos, K.; Williams, Maggie

doi:10.1016/j.atherosclerosis.2015.10.047

Cited by 2 publications

(2 citation statements)

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“…6 To add to the confusion, there are multiple sets of clinical criteria for the diagnosis of FH, of which three are statistically and genetically validated criteria and most commonly used: the Dutch, 8 the Simon Broome UK, 9 and the MEDPED US criteria. 10 Genetic testing remains relatively expensive, costing approximately £250 for an index test; 11 although these costs have reduced considerably in recent years 12 due to higher volumes of testing and more cost-efficient techniques. Ultimately, we need to establish whether a test is clinically justified in terms of risk stratification and prediction of cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of cardiovascular events in genetically confirmed versus unconfirmed familial hypercholesterolaemia

Khan

Breen

Neves

et al. 2020

gcsp

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Introduction: Genetic testing for familial hypercholesterolaemia (FH) is not yet established for widespread use internationally to provide diagnostic confirmation, in part due to high cost and resource requirement. We need to establish whether genetic testing is clinically justified in terms of risk stratification and prediction of cardiovascular events.Methods: We performed a single tertiary cardiac centre retrospective evaluation of patients with FH managed within our genetic screening service. We evaluated the prevalence of cardiovascular events in genetically confirmed cases of FH compared to those unconfirmed upon genetic testing, to assess whether gene positivity confers a higher risk phenotype. We also compared the clinical characteristics of the genetically confirmed and unconfirmed group.Results: Amongst adult patients (≥18 years) with genetically confirmed heterozygous FH (n=87), 34% (30/87) had one or more documented CV events. In comparison a lower event rate was observed in adult patients with genetically unconfirmed FH (n=170) with 25% (42/170) experiencing one or more documented CV events. Additional cardiovascular risk factors were more prevalent in the unconfirmed group including hypertension, co- morbidities, higher age and body mass index which may have modified the difference in cardiovascular risk.Conclusion: Genetic testing in FH may be clinically justified and appears to identify a subset of patients with higher risk of cardiovascular events. However, the risk difference is modified by alternative cardiovascular risk factors and co-morbidities which may be more prevalent in genetically unconfirmed FH.

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Section: Introductionmentioning

confidence: 99%