Screening of familial hypercholesterolemia among patients in age under 40 years old exposed by duplex scanning of carotid arteries, by the local registry data

Gaisenok, O. V.; Владимирович, Гайсёнок Олег; Kurnosov, P A; Алексеевич, Курносов Павел; Leonov, A S; Сергеевич, Леонов Антон; Zateyshchikov, Dmitry A.; Александрович, Затейщиков Дмитрий

doi:10.26442/terarkh201890937-41

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…В данный регистр были последовательно включены результаты обследования пациентов, которым было выполнено ДССА в ФГБУ "Объединенная больница с поликлиникой" Управления делами Президента РФ в период с 1 января по 31 декабря 2013г. Подробная методология создания данного регистра отражена в предыдущих публикациях [11,12].…”

Section: материал и методыunclassified

Can a referral diagnosis code for duplex ultrasound "predict" carotid artery stenosis?

Gaisenok

Samorodskaya²,

Drapkina³

2023

Cardiovasc Ther Prev

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Aim. To evaluate the detection rate of carotid artery stenosis (CAS) based on the diagnosis code according to the International Classification of Diseases of 10th revision (ICD-10), used in appointment card for carotid duplex ultrasound.Material and methods. To conduct this study, the Duplex-2013 registry database was used, which sequentially included 2548 patients. When referring to carotid duplex ultrasound, all patients indicated the ICD-10 diagnosis code as the main reason for seeking medical help. The study assessed the presence and severity of CAS, the probability of CAS, taking into account age, sex, and referral diagnosis according to ICD-10.Results. According to the results of a univariate analysis, the following referral diagnoses were associated with the identification of CAS by two criteria (stenosis ≥20 and ≥50%): generalized/peripheral atherosclerosis (GPA) — odds ratio (OR), 6,54; 95% confidence interval (CI): 2,71-18,89 (p<0,001) and OR, 11,91; 95% CI: 6,17-22,75 (p<0,001), postinfarction cardiosclerosis — OR, 5,63; 95% CI: 2,62-13,6 (p<0,001) and OR, 3,08; 95% CI: 1,39-6,28 (p=0,004), CAS — OR, 3,26; 95% CI: 2,08-5,27 (p<0,001) and OR, 2,29; 95% CI: 1,25-3,96 (p=0,006) and hypertension, OR, 2,2; 95% CI: 1,87-2,58 (p<0,0001) and OR, 1,45; 95% CI: 1,07-1,97 (p=0,02). Taking into account age and sex, the probability of CAS detection (>20%) is associated with HTN — OR, 1,43; 95% CI: 1,19-1,71 (p<0,001), postinfarction cardiosclerosis — OR, 2,89; 95% CI: 1,20-6,94 (p=0,01) and GPA — OR, 4,52; 95% CI: 1,65-12,35 (p=0,003); CAS >50% — acute myocardial infarction — OR, 8,45; 95% CI: 1,32-53,97 (p=0,02) and GPA — OR, 9,82; 95% CI: 4,81-20,04 (p<0,001).Conclusion. Certain groups of referral diagnoses (ICD-10 codes) are associated with a higher probability of CAS. The obtained data needs to be refined in order to optimize routing and referral for carotid duplex ultrasound.

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Section: материал и методыunclassified

Can a referral diagnosis code for duplex ultrasound "predict" carotid artery stenosis?

Gaisenok

Samorodskaya²,

Drapkina³

2023

Cardiovasc Ther Prev

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“…The Duplex registry database was used for this study. The detailed methodology for conducting this registry was described earlier in previous publications (Gaisenok et al 2018;Gaisenok and Drapkina 2022). The registry protocol conforms to the ethical guidelines of the Helsinki Declaration.…”

Section: Group Descriptionmentioning

confidence: 99%

Analysis of the frequency of detection of hypercholesterolemia, carotid atherosclerosis and lipid-lowering therapy prescription in young adults under 45 years old according to the Duplex registry database

Gaisenok

2023

RRP

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Aim of the study to analyze the detection of hypercholesterolemia (HCHL) and carotid atherosclerosis (CAS), verified by duplex scanning of the carotid arteries (DSCA) in young adults (YA), and to evaluate the lipid-lowering therapy (LLT) prescription among them according to the local registry database. Material and Methods: The Duplex registry database was used for this study (n=2548). YA up to 45 years old were selected for the final analysis (n=351). Results: HCHL (> 5 mmol/L) was detected in 68.9% of patients (n=241), and only 9.5% of them received LLT (n=23). CAS was detected in 12.8% (n=45), only 17.8% of them had received LLT (n=8). Men and women differed 1.5 times by the incidence of CAS in this age range: 15.7% (30 out of 191) vs 9.4% (15 out of 160), p=0.05. Men also generally have a higher prevalence of other risk factors/diseases: HCHL (78.0% (n=149) vs 58.1% (n=93) in women, p=0.00004), hypertension (AH) (15.7% (n=30) vs 9.4% (n=15) in women, p=0,05), history of myocardial infarction (MI) (1,6% (n=3) vs 0% (n=0) in women, ns). Signs that had a significant impact on LLT intake were the following: CAS (OR 2.8 [1.09;6.6] p=0.036); AH (OR 3.1 [1.32; 7.16] p=0.009); HCHL (> 5 mmol/L) (OR 4.2 [1.12; 26.83] p=0.06); HCHL (ICD-10 code E78) (OR 5.4 [2.04; 13.7] p=0.0003); MI history (OR 22.3 [1.65;675.5] p=0.009). Conclusion: The insufficient LLT prescription in young adults with HCHL and CAS was ascertained in the present study. The use of imaging methods to clarify the degree of cardiovascular risk is advisable for low and intermediate risk patients, which include young adults. DSСA is the main method for subclinical atherosclerosis verification. LLT should be prescribed to all YA patients with CAS (in the absence of contraindications). Graphical Abstract

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“…Материалы и методы. Для данного исследования была использована база данных «Регистра Дуплекс», подробная методология проведения которого описана ранее в предыдущих публикациях [14,15]. Каротидный атеросклероз верифицировался на основании данных дуплексного сканирования при наличии атеросклеротической бляшки, стенозирующей просвет сонной артерии на 20 % и более.…”

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Forecasting risk analysis of detection for carotid artery stenosis based on serum levels grading of lipoprotein (a)

Gaisenok¹

2022

Health Risk Analysis

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Aim of the study: to assess the relationship between Lp(a) serum levels grading and carotid artery stenosis (CAS). The Duplex Registry database was used for this study. CAS was verified by duplex scanning in the presence of an atherosclerotic plaque (AP), stenosing the lumen of the carotid artery (CA) by 20 % or more. Patients who underwent a blood test for Lp(a) and the results were entered into the registry database were selected for this study. The immunoturbidimetric method was used to determine the serum level of Lp(a) (mg/dl). Data from 51 patients (66.6 % men) were included in the final analysis: median age 49.0 [46.0; 59], total cholesterol (TC) 5.93 [5.13; 6.56], Lp(a) 26.5 [14.2; 76.0]. Spearman rank correlation analysis showed the presence of significant relationships (p < 0.05) between Lp(a) and age (r = 0.3), gender (r = 0.3), the presence of AP in the right ICA (r = 0.5), HDL (r = 0.3). OR and 95 % CI were calculated to determine the effect of Lp(a) grades on the probability of CAS detection: Lp(a) < 30 mg/dl OR 0.36 [0.11; 1.14] p = 0.04; Lp(a) > 30 mg/dl OR 1.42 [0.44; 4.58] p = 0.27. The prevalence of CAS in the group with Lp(a) level < 30 mg/dl was 33.3 %, 30–50 mg/dl – 50 %, 50–100 mg/dl – 40 %, > 100 mg/dl – 37.5 %. The model of multiple regression analysis for Lp(a) with TC in relation to the right ICA stenosis predicting showed R = 0.51, F = 8.4, p = 0.0007. The statistics of 3M model of the logistic regression function for CAS predicting based on the Lp(a) and TC data showed: -2 • log(likelihood) = 57.16, Chi-square = 8.17 (cc = 2), p = 0.016. The present study confirmed the relationship between the Lp(a) level and the CAS detection and the presence of an additive effect of total cholesterol on this. The reference role of Lp(a) gradation at the level of 30 mg/dl was determined as significant in relation to predicting CAS detection.

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Screening of familial hypercholesterolemia among patients in age under 40 years old exposed by duplex scanning of carotid arteries, by the local registry data

Cited by 5 publications

References 19 publications

Can a referral diagnosis code for duplex ultrasound "predict" carotid artery stenosis?

Can a referral diagnosis code for duplex ultrasound "predict" carotid artery stenosis?

Analysis of the frequency of detection of hypercholesterolemia, carotid atherosclerosis and lipid-lowering therapy prescription in young adults under 45 years old according to the Duplex registry database

Forecasting risk analysis of detection for carotid artery stenosis based on serum levels grading of lipoprotein (a)

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