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Pérez de Isla L, Arroyo-Olivares R, Alonso R, Muñiz-Grijalvo O, Díaz-Díaz JL, Zambón D, Fuentes F, Mata N, Piedecausa M, Mañas MD, Sánchez Muñoz-Torrero JF, Miramontes-González JP, de Andrés R, Mauri M, Aguado R, Brea Á, Cepeda JM, Vidal-Pardo JI, Martínez-Faedo C, Barba MÁ, Argüeso R, Ruiz-Pérez E, Michán A, Arrieta F, Riestra Fernández M, Pérez L, Pinilla JM, Díaz-Soto G, Pintó X, Padró T, Badimón L, Mata P. Incidence of cardiovascular events and changes in the estimated risk and treatment of familial hypercholesterolemia: the SAFEHEART registry. Rev Esp Cardiol (Engl Ed) 2020; 73:828-834. [PMID: 32201274 DOI: 10.1016/j.rec.2019.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES The SAFEHEART study was designed to analyze the situation of familial heterozygous hypercholesterolemia (FHH) and improve knowledge of this disease in Spain. Our objective was to determine the incidence rate of cardiovascular events, the estimated risk of developing an event and its modification, the use of lipid-lowering treatment, and the achievement of low-density lipoprotein cholesterol targets in patients with FHH. METHODS SAFEHEART is a prospective, open, multicenter, nationwide cohort study, with long-term protocol-based follow-up in a population of individuals with molecularly-characterized FHH. We analyzed patients older than 18 years with complete follow-up. RESULTS We included 2648 patients with FHH. The median follow-up was 6.6 (4.8-9.7) years. The overall incidence rate of cardiovascular events was 1.3 events/100 patient-years. After the follow-up, the 10-year estimated risk of developing a cardiovascular event was reduced from 1.6% to 1.3% (P <.001). In the last follow-up, 20.6% and 22.2% of the patients in primary and secondary prevention achieved low-density lipoprotein cholesterol values <100mg/dL and <70mg/dL, respectively. CONCLUSIONS This study was performed in the largest population of patients with FHH in Spain. We identified the incidence rate of cardiovascular events, the estimated risk of developing a cardiovascular event and its modification, the achievement of low-density lipoprotein cholesterol targets, and the therapeutic management in this population. Although the cardiovascular risk of FHH is high, appropriate treatment reduces the likelihood of an event. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov. Identifier: NCT02693548.
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Affiliation(s)
- Leopoldo Pérez de Isla
- Servicio de Cardiología, Hospital Clínico San Carlos, IDISSC, Madrid, Spain; Fundación Hipercolesterolemia Familiar, Madrid, Spain.
| | | | - Rodrigo Alonso
- Fundación Hipercolesterolemia Familiar, Madrid, Spain; Departamento de Nutrición, Clínica Las Condes, Santiago de Chile, Chile
| | | | | | - Daniel Zambón
- Servicio de Endocrinología, Hospital Clínico de Barcelona, Barcelona, Spain
| | - Francisco Fuentes
- Unidad de Lípidos y Arteriosclerosis, IMIBIC, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Nelva Mata
- Departamento de Epidemiología, Consejería de Sanidad, Madrid, Spain
| | - Mar Piedecausa
- Servicio de Medicina Interna, Hospital de Elche, Elche, Alicante, Spain
| | - M Dolores Mañas
- Servicio de Medicina Interna, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | | | | | - Marta Mauri
- Servicio de Medicina Interna, Hospital de Terrassa, Terrassa, Barcelona, Spain
| | - Rocío Aguado
- Servicio de Endocrinología, Hospital Universitario de León, León, Spain
| | - Ángel Brea
- Servicio de Medicina Interna, Hospital San Pedro, Logroño, Spain
| | - José M Cepeda
- Servicio de Medicina Interna, Hospital Comarcal Vega Baja, Orihuela, Alicante, Spain
| | | | | | - Miguel Ángel Barba
- Servicio de Medicina Interna, Hospital General de Albacete, Albacete, Spain
| | - Rosa Argüeso
- Servicio de Endocrinología, Hospital Lucus Augusti, Lugo, Spain
| | - Enrique Ruiz-Pérez
- Servicio de Endocrinología, Hospital Universitario de Burgos, Burgos, Spain
| | - Alfredo Michán
- Servicio de Medicina Interna, Hospital de Jerez de la Frontera, Cádiz, Spain
| | | | | | - Leire Pérez
- Servicio de Endocrinología, Hospital Universitario de Álava, Vitoria, Spain
| | | | - Gonzalo Díaz-Soto
- Servicio de Endocrinología, Hospital Clínico Universitario, Valladolid, Spain
| | - Xavier Pintó
- Servicio de Medicina Interna, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Padró
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Lina Badimón
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain
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