Prevalence, management, and outcomes of familial hypercholesterolemia in patients with acute coronary syndromes in the Arabian Gulf

Al-Rasadi, Khalid; Al‐Zakwani, Ibrahim; Alsheikh‐Ali, Alawi A.; Almahmeed, Wael; Rashed, Wafa; Ridha, Mustafa; Santos, Raúl D.; Zubaid, Mohammad

doi:10.1016/j.jacl.2018.02.003

Cited by 36 publications

(33 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results in 232 individuals with genetically verified FH who had experienced a first-time AMI support and extend (with 17 years of follow-up) previous results in individuals with probable FH [7,8,[14][15][16][17][18][19]. Rerup and co-workers found that individuals with probable FH had a 1.28-fold increased risk of recurrent AMI after a median of 3.3 years of follow-up [8], whereas Danchin and co-workers found a 2.2-fold increased risk of the combined outcome death or recurrent major cardiovascular events after 5 years of follow-up in probable FH [7].…”

Section: Discussionsupporting

confidence: 84%

2.5-fold increased risk of recurrent acute myocardial infarction with familial hypercholesterolemia

et al. 2021

View full text Add to dashboard Cite

Background and aims: A first-time acute myocardial infarction (AMI) is a severe diagnosis that leads to initiation or intensification of lipid-lowering medication to prevent recurrent events. Individuals with familial hypercholesterolemia (FH) already use high-intensity lipid-lowering medication at the time of an incident AMI due to their diagnosis. Hence, we hypothesized that compared with matched non-FH controls, individuals with genetically verified FH have increased mortality and risk of recurrent AMI after their first event. Methods: The study population comprised 4871 persons with genetically verified FH, and 96,251 age and sex matched controls randomly selected from the Norwegian population. Data were obtained from the Cardiovascular Disease in Norway Project, the Norwegian Patient Registry and the Norwegian Cause of Death Registry. Incidence of AMI, all-cause mortality and recurrent AMI after incident AMI were analyzed for the period 2001-2017. Incidence and mortality were compared using hazard ratios (HR) from Cox regression. Risk of recurrent AMI was compared using sub-hazard ratios (SHR) from competing risk regression with death as a competing event.Results: We identified 232 individuals with FH and 2118 controls with an incident AMI [HR 2.10 (95% CI 1.83-2.41)]. Among survivors ≥29 days after the incident AMI, both mortality [HR = 1.45 (95% CI: 1.07-1.95)] and recurrent AMI [SHR = 2.53 (95% CI: 1.88-3.41)] were significantly increased among individuals with FH compared with non-FH controls. Conclusions: Individuals with FH have increased mortality and increased risk of recurrent AMI after the first AMI event compared with controls. These findings call for intensive follow-up of individuals with FH following an AMI.

show abstract

Section: Discussionsupporting

confidence: 84%

2.5-fold increased risk of recurrent acute myocardial infarction with familial hypercholesterolemia

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A retrospective cohort study of 202 patients with ACS in China demonstrated that patients were more likely to achieve LDL-C goal if they were receiving ezetimibe plus statin (69.1%, P = 0.007) or intensive statin therapy (67.9%, P = 0.047) compared with moderate-intensity statin (46.9%) [31]. Consistent results were reported for a prospective cohort study in 84 Chinese patients with [109,110] 90.7 [110] 100 [89] ACS acute coronary syndrome a For studies that recorded percentage statin use over more than 1 time period, the data for the most recent time period are presented [34]. Rates of statin use were similar in the three groups at discharge (96-98%) and at 1 year post ACS (93-96%); however, goal attainment rates differed between the groups (P \ 0.001); 23% of patients in whom FH was unlikely achieved their LDL-C goal, compared with 13% and 12% of patients with probable and possible FH, respectively.…”

Section: Use Of High-intensity Lmt Statin Therapymentioning

confidence: 52%

“…Auckle et al [ 33 ] reported poorer LDL-C goal achievement (< 1.8 mmol/L or > 50% reduction) with moderate potency LMT at 1 year post STEMI in patients with possible FH compared with those without FH (18.7% vs. 51.4%) in China. In a separate study, patients ( n = 3224) from the GULF COAST registry (2012–2013) were stratified by FH status (probable, possible or unlikely) [ 34 ]. Rates of statin use were similar in the three groups at discharge (96–98%) and at 1 year post ACS (93–96%); however, goal attainment rates differed between the groups ( P < 0.001); 23% of patients in whom FH was unlikely achieved their LDL-C goal, compared with 13% and 12% of patients with probable and possible FH, respectively.…”

Section: Current State Of Dyslipidaemia Management Post Acs In Countrmentioning

confidence: 99%

A Narrative Review and Expert Panel Recommendations on Dyslipidaemia Management After Acute Coronary Syndrome in Countries Outside Western Europe and North America

et al. 2020

Self Cite

View full text Add to dashboard Cite

Patients who have experienced an acute coronary syndrome (ACS) are at very high risk of recurrent atherosclerotic cardiovascular disease (CVD) events. Dyslipidaemia, a major risk factor for CVD, is poorly controlled post ACS in countries outside Western Europe and North America, despite the availability of effective lipid-modifying therapies (LMTs) and guidelines governing their use. Recent guideline updates recommend that low-density lipoprotein cholesterol (LDL-C), the primary target for dyslipidaemia therapy, be reduced by C 50% and to \ 1.4 mmol/L (55 mg/dL) in patients at very high risk of CVD, including those with ACS. The high prevalence of CVD risk factors in some regions outside Western Europe and North America confers a higher risk of CVD on patients in these countries. ACS onset is often earlier in these patients, and they may be more challenging to treat. Other barriers to effective dyslipidaemia control include low awareness of the value of intensive lipid lowering in patients with ACS, physician non-adherence to guideline recommendations, and lack of efficacy of currently used LMTs. Lack of appropriate pathways to guide follow-up of patients with ACS post discharge and poor access to intensive medications are important factors limiting Digital Features To view digital features for this article go to

show abstract

“…For risk factors, Gulf PREVENT will quantify the relative contribution and population attributable risk percentage associated with premature MI, with emphasis on diabetes, obesity, and familial hypercholesterolemia, given their growing prevalence in the Middle East. 34,37 We aim to enroll 400 cases (men 18-55 years; women 18-65 years, with first MI) and a similar number of controls matched by age (+5 years), sex, and nationality. Myocardial infarction will be determined by symptoms, cardiac biomarkers, and electrocardiographic criteria outlined by the American Heart Association/American College of Cardiology.…”

Section: Rationale For the Gulf Prevent Studymentioning

confidence: 99%

Premature Myocardial Infarction in the Middle East and North Africa: Rationale for the Gulf PREVENT Study

et al. 2019

Self Cite

View full text Add to dashboard Cite

The Middle East and North Africa (MENA) region has a high burden of morbidity and mortality due to premature (≤55 years in men; ≤65 years in women) myocardial infarction (MI) and acute coronary syndrome (ACS). Despite this, the prevalence of risk factors in patients presenting with premature MI or ACS is incompletely described. We compared lifestyle, clinical risk factors, and biomarkers associated with premature MI/ACS in the MENA region with selected non-MENA high-income countries. We identified English-language, peer-reviewed publications through PubMed (up to March 2018). We used the World Bank classification system to categorize countries. Patients with premature MI/ACS in the MENA region had a higher prevalence of smoking than older patients with MI/ACS but a lower prevalence of diabetes, hypertension, and dyslipidemia. Men with premature MI/ACS had a higher prevalence of smoking than women but a lower prevalence of diabetes and hypertension. The MENA region had sparse data on lifestyle, diet, psychological stress, and physical activity. To address these knowledge gaps, we initiated the ongoing Gulf Population Risks and Epidemiology of Vascular Events and Treatment (Gulf PREVENT) case–control study to improve primary and secondary prevention of premature MI in the United Arab Emirates, a high-income country in the MENA region.

show abstract

Prevalence, management, and outcomes of familial hypercholesterolemia in patients with acute coronary syndromes in the Arabian Gulf

Abstract: In Arabian Gulf citizens, FH was common in ACS patients, was undertreated, and was associated with a worse 1-year prognosis.

Cited by 36 publications

References 33 publications

2.5-fold increased risk of recurrent acute myocardial infarction with familial hypercholesterolemia

2.5-fold increased risk of recurrent acute myocardial infarction with familial hypercholesterolemia

A Narrative Review and Expert Panel Recommendations on Dyslipidaemia Management After Acute Coronary Syndrome in Countries Outside Western Europe and North America

Premature Myocardial Infarction in the Middle East and North Africa: Rationale for the Gulf PREVENT Study

Contact Info

Product

Resources

About