The effects of 3-year statin therapy and the achievement of LDL cholesterol target values in familial hypercholesterolemia patients: An experience from Serbia

Highlights from the 87th EAS congress, 26–29th May 2019

“…Recent news from the EAS FHSC Registry has highlighted the extent of unmet needs in FH research and care [1], emphasising the importance of this initiative. Professor Kausik Ray (Imperial College, London, UK), who leads the Registry, overviewed new insights from individual lead investigators, including findings from the ELSA-Brazil study showing differences in FH prevalence according to ethnicity [2]; the DIAMOND-FH study in Switzerland showing how low-density lipoprotein cholesterol (LDL-C) levels are influenced by age in people with FH-causing variants in the APOB gene [3]; the impact of universal screening of children on cascade screening for FH in Slovenia [4]; as well as data from Serbia, Slovakia, Uzbekistan and South Africa [5][6][7][8], amongst others, highlighting the issue of undertreatment of FH. In addition, findings from Vietnam emphasised the need for education of FH patients to ensure uptake of statin treatment [9].…”

Improving the global care of familial hypercholesterolaemia: Starting the ball rolling

“…Several of the clinical surveys indicated that FH remains largely undiagnosed and untreated [12,[18][19][20][21][22][23][24][25][26][27], despite meeting all the classical criteria for screening. The prevalence of definite FH is probably 5fold higher among younger patients with an acute coronary syndrome [28] and protocols for linking the detection of such patients to followup in specialist clinics and the cascade testing of relatives for FH have been proposed [29].…”

“…The clinical expression of FH is variable and cardiovascular (CV) risk equations have been described [48]. Several reports show a high prevalence of non-cholesterol risk factors among patients with FH, implying the need to address targets beyond LDL-cholesterol [18,20,[23][24][25][26]49]. Smoking remains a major driver of CV risk across all continents [25,49], providing a major mandate for coronary prevention in FH.…”

“…Therapeutic targets and novel therapies for FH are well reviewed by Raal et al [55]. Reaching LDL-targets remains a universal challenge in managing FH [18,20,[23][24][25][26]49] and requires not only overcoming cost and access barriers to PCSK9 inhibitors, but also addressing the beliefs and perceptions of patients concerning medication [56]. Treatment gaps and related gender and ethnic disparities in the use of statins and attainment of treatment targets have also been underscored by data from the CASCADE-FH Registry in the US [57,58].…”

“…Registries are important not only to raise awareness of FH, but also to garner information necessary for clinical trials and audits, for education of registrants and healthcare professionals, and for health service research and policy making [8,63]. FH registries reported in this series are at different stages of development [16,18,20,21,[24][25][26][27]31,37,39,64]. Through the FHSC there are abundant opportunities for enabling the development of fledgling registries.…”