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Climent E, Millán J, Ascaso JF, Suárez-Tembra M, Morillas C, Civeira F, Bellón JM, Pedro-Botet J. Atherogenic dyslipidaemia in type 2 diabetes mellitus: The PREDISAT study. Lipids 2023; 58:197-206. [PMID: 37291984 DOI: 10.1002/lipd.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
Extremely variable prevalence rates of atherogenic dyslipidaemia (AD) in type 2 diabetes (T2DM) subjects have been reported. The primary aim was to assess AD prevalence in Spanish T2DM subjects. Secondary objectives were to evaluate the differential clinical characteristics between T2DM subjects with and without AD, to describe lipid profile evolution and use of lipid-lowering treatment in clinical practice by the Spanish Lipid Units. Data was obtained from the National Registry of Dyslipidaemias of the Spanish Atherosclerosis Society, from a multicentric sub-study focused on AD prevalence in T2DM subjects (PREDISAT study). The inclusion criteria were subjects diagnosed of T2DM with age ≥18 years old. A total of 385 T2DM subjects with a mean age of 61 years and 246 (64%) men were included. The mean follow-up was 22 ± 7.4 months. At baseline, 41.3% of the T2DM subjects presented AD, this percentage decreasing to 34.8% with therapeutic intervention. AD prevalence varied in different age groups and appeared to be more prevalent in younger T2DM subjects. Those with AD had a more atherogenic lipid profile at baseline, with higher total cholesterol, triglyceride and non-(high-density lipoprotein) HDL cholesterol levels at baseline, together with lower HDL cholesterol concentrations, without achieving lipid subfraction goals during follow-up. Although almost 90% of the AD subjects were under lipid-lowering treatment, most were receiving only one drug, being statins the most used treatmentA high AD prevalence in T2DM subjects was observed, being age a determinant factor, with a modest decline during follow-up. Although almost 90% of the AD subjects were under lipid-lowering drugs, most were only receiving monotherapy with statins.
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Affiliation(s)
- Elisenda Climent
- Department of Endocrinology and Nutrition, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Millán
- School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Juan F Ascaso
- School of Medicine, University of Valencia, Valencia, Spain
| | | | - Carlos Morillas
- Lipid Unit, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Fernando Civeira
- Lipid Unit, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Jose M Bellón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Juan Pedro-Botet
- Department of Endocrinology and Nutrition, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
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Marco-Benedí V, Bea AM, Sánchez Hernández RM, Plana N, Valdivielso P, Civeira F. Dyslipidemia treatment strategies in primary and secondary prevention. Dyslipemia Registry of the Spanish Arteriosclerosis Society. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34:303-310. [PMID: 35654677 DOI: 10.1016/j.arteri.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Clinical studies show that patients with high cardiovascular risk are still far from reaching the therapeutic objectives, especially of the levels of LDL cholesterol. If the management of these patients in specialized units differs from other scenarios is known. PATIENTS AND METHODS 61 certified Lipid Units were selected in the Registry of Dyslipemias of the Spanish Arteriosclerosis Society for the collection of study data. The study included 3958 subjects >18 years of age who met the criteria for hypercholesterolemia (LDL cholesterol ≥160 mg/dL or non-HDL cholesterol ≥190 mg/dL) without familial hypercholesterolemia. A total 1,665 subjects were studied with a mean follow-up time of 4.2 years. RESULTS AND CONCLUSIONS A total of 42 subjects had a cardiovascular event since their inclusion in the Registry, which represents 0.6%. There were no differences in the treatment used at follow-up, but 50% of the patients did not reach the therapeutic goals at the visit end of follow-up. An increase in the potency of the lipid-lowering treatment was observed, including PCSK9 inhibitors use in 16.7% of subjects with recurrences.
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Affiliation(s)
- Victoria Marco-Benedí
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, España; Universidad de Zaragoza, Zaragoza, España
| | - Ana M Bea
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, España
| | - Rosa M Sánchez Hernández
- Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, España; Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Núria Plana
- Unidad de Medicina Vascular y Metabolismo, Hospital Universitari Sant Joan, Reus, Instituto de Investigación Sanitaria Pere Virgili (IISPV), CIBERDEM, Universidad Rovira i Virgili, Tarragona, España
| | - Pedro Valdivielso
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Virgen de la Victoria, Departamento de Medicina y Dermatología, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Málaga, España
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, España; Universidad de Zaragoza, Zaragoza, España.
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Marco-Benedí V, Cenarro A, Laclaustra M, Larrea-Sebal A, Jarauta E, Lamiquiz-Moneo I, Calmarza P, Bea AM, Plana N, Pintó X, Martín C, Civeira F. Lipoprotein(a) in hereditary hypercholesterolemia: Influence of the genetic cause, defective gene and type of mutation. Atherosclerosis 2021; 349:211-218. [PMID: 34456049 DOI: 10.1016/j.atherosclerosis.2021.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Lipoprotein(a) [Lp(a)] concentration in heterozygous familial hypercholesterolemia (heFH) is not well established. Whether the genetic defect responsible for heFH plays a role in Lp(a) concentration is unknown. We aimed to compare Lp(a) in controls from a healthy population, in genetically diagnosed heFH and mutation-negative hypercholesterolemia subjects, and to assess the influence on Lp(a) of the genetic defect responsible for heFH. METHODS We conducted a cross-sectional study, performed in a lipid clinic in Spain. We studied adults with suspected heFH and a genetic study of FH genes (LDLR, APOB, APOE and PCSK9) and controls from de Aragon Workers' Health Study. HeFH patients from the Dyslipidemia Registry of the Spanish Atherosclerosis Society (SEA) were used as validation cohort. RESULTS Adjusted geometric means (95% confidence interval) of Lp(a) in controls (n = 1059), heFH (n = 500), and mutation-negative subjects (n = 860) were 14.9 mg/dL (13.6, 16.4), 21.9 mg/dL (18.1, 25.6) and 37.4 mg/dL (33.3, 42.1), p < 0.001 in all comparisons. Among heFH subjects, APOB-dependent FH showed the highest Lp(a), 36.5 mg/dL (22.0, 60.8), followed by LDLR-dependent FH, 21.7 mg/dL (17.9, 26.4). These differences were also observed in heFH from the SEA cohort. The number of plasminogen-like kringle IV type-2 repeats of LPA, the hypercholesterolemia polygenic score or LDLc concentration did not explain these differences. In LDLR-dependent FH, Lp(a) levels were not different depending on the affected protein domain. CONCLUSIONS Lp(a) is elevated in mutation-negative subjects and in heFH. The concentration of Lp(a) in heFH varies in relation to the responsible gene. Higher Lp(a) in heFH is not explained by their higher LDLc.
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Affiliation(s)
- Victoria Marco-Benedí
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana Cenarro
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain
| | - Martín Laclaustra
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, Universidad de Zaragoza, Zaragoza, Spain.
| | - Asier Larrea-Sebal
- Fundación Biofisika Bizkaia, Leioa, Spain; Biofisika Institute (UPV/EHU, CSIC), Leioa, Spain, Department of Biochemistry and Molecular Biology, Universidad del País Vasco UPV/EHU, Bilbao, Spain
| | - Estíbaliz Jarauta
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, Universidad de Zaragoza, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, Universidad de Zaragoza, Zaragoza, Spain
| | - Pilar Calmarza
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain
| | - Ana M Bea
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain
| | - Núria Plana
- Unitat de Medicina Vascular i Metabolisme (UVASMET) Hospital Universitari Sant Joan, IISPV, CIBERDEM, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Xavier Pintó
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-Idibell, Universidad de Barcelona, CiberObn, Barcelona, Spain
| | - César Martín
- Fundación Biofisika Bizkaia, Leioa, Spain; Biofisika Institute (UPV/EHU, CSIC), Leioa, Spain, Department of Biochemistry and Molecular Biology, Universidad del País Vasco UPV/EHU, Bilbao, Spain
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology, Universidad de Zaragoza, Zaragoza, Spain.
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Arrobas Velilla T, Brea Á, Valdivielso P. Implantation of a biochemical and genetic screening programme for family hypercholesterolaemia. Collaboration between the clinical laboratory and lipid units: Design of the ARIAN Project. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2021; 33:289-295. [PMID: 34090714 DOI: 10.1016/j.arteri.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVE Familial hypercholesterolaemia (FH) is the most common genetic disorder associated with premature coronary artery disease due to the presence of LDL-C cholesterol increased from birth. It is underdiagnosed and undertreated. The primary objective of the ARIAN project was to determine the number of patients diagnosed with FH after implementing a new screening procedure from the laboratory. MATERIAL AND METHODS This project was designed as a retrospective analysis by consulting the computer system. We selected from databases serum samples from patients ≥ 18 years with direct or calculated LDL-C>250mg/dL from 1 January 2017 to 31 December 2018. Once secondary causes had been ruled out, the requesting primary care physician was notified that their patient might have FH and to arrange a priority appointment in the lipid unit. All patients with a score of ≥ 6 points according to the Dutch Lipid Clinic Criteria were proposed for a genetic study RESULTS: By December 30th, 2020, 24 centres out of the initial 55 had submitted results. The number of patients analysed up to that point was 3,266,341, which represents 34% of the population served in those health areas (9,727,434). CONCLUSIONS The identification of new subjects with FH through this new strategy from the laboratory and their referral to lipid units should increase the number of patients treated in lipid units and initiate familial cascade screening.
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Affiliation(s)
- Teresa Arrobas Velilla
- Laboratorio de Nutrición y Riesgo Cardiovascular de Bioquímica Clínica, Unidad de Lípidos, Hospital Universitario Virgen de la Macarena, Sevilla, España.
| | - Ángel Brea
- Servicio de Medicina Interna y Unidad de Lípidos, Hospital San Pedro, Logroño, La Rioja, España
| | - Pedro Valdivielso
- Servicio de Medicina Interna y Unidad de Lípidos, Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, España
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Climent E, Marco-Benedí V, Benaiges D, Pintó X, Suárez-Tembra M, Plana N, Lafuente H, Ortega-Martínez de Victoria E, Brea-Hernando Á, Vila À, Civeira F, Pedro-Botet J. Impact of statin therapy on LDL and non-HDL cholesterol levels in subjects with heterozygous familial hypercholesterolaemia. Nutr Metab Cardiovasc Dis 2021; 31:1594-1603. [PMID: 33744038 DOI: 10.1016/j.numecd.2021.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/13/2021] [Accepted: 01/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Cardiovascular risk in heterozygous familial hypercholesterolaemia (HeFH) is driven by LDL cholesterol levels. Since lipid response to statin therapy presents individual variation, this study aimed to compare mean LDL and non-HDL cholesterol reductions and their variability achieved with different types and doses of the most frequently prescribed statins. METHODS AND RESULTS Among primary hypercholesterolaemia cases on the Spanish Arteriosclerosis Society registry, 2894 with probable/definite HeFH and complete information on drug therapy and lipid profile were included. LDL cholesterol reduction ranged from 30.2 ± 17.0% with simvastatin 10 mg to 48.2 ± 14.7% with rosuvastatin 40 mg. After the addition of ezetimibe, an additional 26, 24, 21 and 24% reduction in LDL cholesterol levels was obtained for rosuvastatin, 5, 10, 20 and 40 mg, respectively. Subjects with definite HeFH and a confirmed genetic mutation had a more discrete LDL cholesterol reduction compared to definite HeFH subjects with no genetic mutation. A suboptimal response (<15% or <30% reduction in LDL cholesterol levels, respectively with low-/moderate-intensity and high-intensity statin therapy) was observed in 13.5% and, respectively, 20.3% of the subjects. CONCLUSION According to the LDL cholesterol reduction in HeFH patients, the ranking for more to less potent statins was rosuvastatin, atorvastatin and simvastatin; however, at maximum dosage, atorvastatin and rosuvastatin were nearly equivalent. HeFH subjects with positive genetic diagnosis had a lower lipid-lowering response. Approximately 1 in 5 patients on high-intensity statin therapy presented a suboptimal response.
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Affiliation(s)
- Elisenda Climent
- Endocrinology and Nutrition Department. Hospital Del Mar; Paseo Marítimo, 25-29; E-08003, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar; Dr. Aiguader, 80; E-08003, Barcelona, Spain
| | - Victoria Marco-Benedí
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - David Benaiges
- Endocrinology and Nutrition Department. Hospital Del Mar; Paseo Marítimo, 25-29; E-08003, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar; Dr. Aiguader, 80; E-08003, Barcelona, Spain; Institut Hospital Del Mar D'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80; E-08003, Barcelona, Spain
| | - Xavier Pintó
- Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital de Bellvitge, CIBEROBN, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Núria Plana
- Unitat de Medicina Vascular i Metabolisme, Hospital Universitari Sant Joan. IISPV, CIBERDEM, Universitat Rovira i Virgili, Reus, Spain
| | - Hannia Lafuente
- Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital de Bellvitge, CIBEROBN, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Ángel Brea-Hernando
- Lipid Unit, Department of Internal Medicine, Hospital San Pedro, Logroño, Spain
| | - Àlex Vila
- Lipid Unit, Department of Internal Medicine, Hospital de Figueres, Figueres, Girona, Spain
| | - Fernando Civeira
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Juan Pedro-Botet
- Endocrinology and Nutrition Department. Hospital Del Mar; Paseo Marítimo, 25-29; E-08003, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona. Campus Universitari Mar; Dr. Aiguader, 80; E-08003, Barcelona, Spain; Institut Hospital Del Mar D'Investigacions Mèdiques (IMIM), Dr. Aiguader, 80; E-08003, Barcelona, Spain.
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Maternally inherited hypercholesterolemia does not modify the cardiovascular phenotype in familial hypercholesterolemia. Atherosclerosis 2021; 320:47-52. [PMID: 33529866 DOI: 10.1016/j.atherosclerosis.2021.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/30/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is a codominant autosomal disease characterized by a high risk of cardiovascular disease when not in lipid-lowering treatment. However, there is a large variability in the clinical presentation in heterozygous subjects (HeFH). Maternal hypercholesterolemia has been proposed as a cardiometabolic risk factor later in life. Whether this phenotype variability depends on the mother or father origin of hypercholesterolemia is unknown. The objective of this study was to analyze potential differences in anthropometry, superficial lipid deposits, comorbidities, and lipid concentrations depending on the parental origin of hypercholesterolemia within a large group of HeFH. METHODS This is a cross-sectional observational, multicenter, nation-wide study in Spain. We recruited adults with HeFH to study clinical differences according to the parental origin. Data on HeFH patients were obtained from the Dyslipidemia Registry of the Spanish Atherosclerosis Society. RESULTS HeFH patients were grouped in 1231 HeFH-mother-offspring aged 45.7 (16.3) years and 1174 HeFH-father-offspring aged 44.8 (16.7) years. We did not find any difference in lipid parameters (total cholesterol, triglycerides, LDLc, HDLc, and Lp(a)), nor in the comorbidities studied (cardiovascular disease prevalence, age of onset of cardiovascular disease, obesity, diabetes, and hypertension) between groups. Lipid-lowering treatment did not differ between groups. The prevalence of comorbidities did not show differences when they were studied by age groups. CONCLUSIONS Our research with a large group of subjects with HeFH shows that a potential maternal effect is not relevant in FH. However, due to the size of our sample, potential differences between genders cannot be completely ruled out. This implies that severe maternal hypercholesterolemia during pregnancy is not associated with additional risk in the FH affected offspring.
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Comparative efficacy between atorvastatin and rosuvastatin in the prevention of cardiovascular disease recurrence. Lipids Health Dis 2019; 18:216. [PMID: 31829197 PMCID: PMC6905000 DOI: 10.1186/s12944-019-1153-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/26/2019] [Indexed: 12/18/2022] Open
Abstract
Background There is no randomized clinical trials with recurrence of atherosclerotic cardiovascular disease (ASCVD) as a major outcome with rosuvastatin. In order to analyze potential differences in the clinical response to atorvastatin and rosuvastatin in secondary ASCVD prevention, we have analyzed the clinical evolution of those subjects of the Dyslipemia Registry of the Spanish Society of Arteriosclerosis (SEA) who at the time of inclusion in the Registry had already suffered an ASCVD. Methods This observational, retrospective, multicenter, national study was designed to determine potential differences between the use of atorvastatin and rosuvastatin in the ASCVD recurrence. Three different follow-up start-times were performed: time of inclusion in the registry; time of first event if this occurred after 2005, and time of first event without date restriction. Results Baseline characteristics were similar between treatment groups. Among atorvastatin or rosuvastatin users, 89 recurrences of ASCVD were recorded (21.9%), of which 85.4% were coronary. At the inclusion of the subject in the registry, 345 participants had not suffered a recurrence yet. These 345 subjects accumulated 1050 person-years in a mean follow-up of 3 years. Event rates were 2.73 (95% CI: 1.63, 4.25) cases/100 person-years and 2.34 (95% CI: 1.17, 4.10) cases/100 person-years in the atorvastatin and rosuvastatin groups, respectively. There were no statistically significant differences between the two groups independently of the follow-up start-time. Conclusions This study does not find differences between high doses of rosuvastatin and atorvastatin in the recurrence of ASCVD, and supports their use as clinically equivalent in secondary prevention of ASCVD.
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Perez-Calahorra S, Laclaustra M, Marco-Benedí V, Lamiquiz-Moneo I, Pedro-Botet J, Plana N, Sanchez-Hernandez RM, Amor AJ, Almagro F, Fuentes F, Suarez-Tembra M, Civeira F. Effect of lipid-lowering treatment in cardiovascular disease prevalence in familial hypercholesterolemia. Atherosclerosis 2019; 284:245-252. [PMID: 30827715 DOI: 10.1016/j.atherosclerosis.2019.02.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/09/2019] [Accepted: 02/01/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS The impact on heterozygous familial hypercholesterolemia (HeFH) health led by high-intensity lipid-lowering therapy (HILLT) is unknown, and the question remains if there is still an unacceptably high residual risk to justify treatment with new lipid-lowering drugs. METHODS This observational, retrospective, multicenter, national study in Spain, whose information was obtained from a national dyslipemia registry, was designed to establish the current prevalence of cardiovascular disease (CVD) in HeFH and to define the impact of HILLT on CVD in this population. Odds were estimated using several logistic regression models with progressive adjustment. RESULTS 1958 HeFH, mean age 49.3 ± 14.3 years, were included in the analysis. At inclusion in the registry, 295 patients (15.1%) had suffered CVD and 164 (55.6%) had suffered the first event before the onset lipid-lowering treatment. Exposition to treatment associated more than ten times lower odds for CVD than in subjects naïve to treatment (OR 0.085, 95% CI 0.063-0.114, p < 0.001). A first CVD event after a mean treatment period of 9.1 ± 7.2 years occurred in 131 out of 1615 (8.1%) HeFH subjects, and 115 (87.8%) of them were on HILLT. CONCLUSIONS Current prevalence of CVD among HeFH is one third of that reported before the statins era. Early initiation and prolonged lipid-lowering treatment was associated with a reduction in CVD. New cases of CVD, in spite of HILLT, appeared mostly among patients accumulating risk factors and probably they may be considered for further lipid-lowering drugs.
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Affiliation(s)
- Sofía Perez-Calahorra
- Lipid Unit. Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Martín Laclaustra
- Lipid Unit. Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Victoria Marco-Benedí
- Lipid Unit. Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Lipid Unit. Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Juan Pedro-Botet
- Lipid and Vascular Risk Unit, Department of Endocrinology and Nutrition, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Núria Plana
- Unitat de Medicina Vascular i Metabolism, Hospital Universitari Sant Joan, Institut d'Investigación Sanitaria Pere Virgili (IISPV), CIBERDEM, Reus, Tarragona, Spain
| | - Rosa M Sanchez-Hernandez
- Lipid Unit, Endocrinology Department, Hospital Universitario Insular de Gran Canaria, Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de, Gran Canaria, Spain
| | - Antonio J Amor
- Lipid Unit, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, CIBEROBN, Barcelona, Spain
| | - Fátima Almagro
- Lipid Unit, Hospital Universitario Donostia, San Sebastián, Spain
| | - Francisco Fuentes
- Lipid Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, CIBEROBN, Universidad de Córdoba, Spain
| | | | - Fernando Civeira
- Lipid Unit. Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain; Universidad de Zaragoza, Zaragoza, Spain.
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Ariza MJ, Rioja J, Ibarretxe D, Camacho A, Díaz-Díaz JL, Mangas A, Carbayo-Herencia JA, Ruiz-Ocaña P, Lamíquiz-Moneo I, Mosquera D, Sáenz P, Masana L, Muñiz-Grijalvo O, Pérez-Calahorra S, Valdivielso P, Suárez Tembra M, Iglesias GP, Carbayo Herencia J, Guerrero Buitrago C, Vila L, Morales Coca C, Llargués Rocabruna E, Perea Castillo V, Pedro-Botet J, Climent E, Mauri Pont M, Pinto X, Ortega Martínez de la Victoria E, Amor J, Zambón Rados D, Blanco Vaca F, Ramiro Lozano J, Fuentes Jiménez F, Soler I, Ferrer C, Zamora Cervantes A, Vila Belmonte A, Novoa Mogollón F, Sanchez-Hernández R, Expósito Montesdeoca A, Romero Jiménez M, González García M, Bueno Díez M, Brea Hernando A, Lahoz C, Mostaza Prieto J, Millán Núñez-Cortés J, Reinares García L, Blanco Echevarría A, Ariza Corbo MJ, Rioja Villodres J, Sánchez-Chaparro M, Jansen Chaparro S, Sáenz Aranzubía P, Martorell Mateu E, Almagro Múgica F, Muñiz Grijalvo O, Masana Martín L, Plana Gil N, Ibarretxe Gerediaga D, Rodríguez Borjabad C, Zabala López S, Hernández Mijares A, Ascaso Gimilio J, Pérez García L, Civeira Murillo F, Pérez-Calahorra S, Lamiquiz-Moneo I, Mateo Gallego R, Marco Benedí V, Ferrando Vela J. Molecular basis of the familial chylomicronemia syndrome in patients from the National Dyslipidemia Registry of the Spanish Atherosclerosis Society. J Clin Lipidol 2018; 12:1482-1492.e3. [DOI: 10.1016/j.jacl.2018.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/09/2018] [Accepted: 07/24/2018] [Indexed: 01/16/2023]
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Civeira F, Pocoví M. Familial hypercholesterolemia in pediatric patients. The success begins here. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2018; 30:179-180. [PMID: 29986810 DOI: 10.1016/j.arteri.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Fernando Civeira
- Instituto De Investigación Sanitaria Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España.
| | - Miguel Pocoví
- Instituto De Investigación Sanitaria Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
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