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Incidence of cardiovascular disease among individuals with and without familial hypercholesterolemia attending a lipid clinic
Abstracts / Atherosclerosis 252 (2016) e1ee196
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treatment compared with non-FH subjects (64 vs 28% and 62 vs 19%, p <0.05, respectively). Among those at high cardiovascular risk, both the FH and non-FH subjects achieved similar rates of LDL-C goal achievement (37 vs 44%, p¼NS). Among those at very high risk, those with FH were less likely to achieve levels of LDL-C <70 mg/dL compared with non-FH (15 vs 25%, p <0.05). Conclusions: A higher proportion of patients with FH receives a high-intensity statin or combination of lipid-lowering drugs compared with the non-FH individuals in a lipid clinic. Nevertheless, not all the individuals with FH either receive high-intensity statin ± ezetimibe or achieve optimal LDL-C levels.
atorvastatin treatment, LDL cholesterol (LDL-C) plasma levels decreased by 44%, 50%, and 53%, respectively (all, P < .0001). Atorvastatin reduced lowdensity LDL-C plasma levels in patients with PHC (48% reduction), FCHL (53%), and FH (46%) (all, P < .0001). Plasma levels of medium-density and high-density LDL-C were also significantly reduced in the 3 patient groups (all, P .0147). LDL-receptor activity was negatively correlated with baseline levels of medium-density LDL-C and with the decreases in plasma md-LDL-C levels. Conclusions: Atorvastatin decreased the levels of the 3 LDL fractions. The md-LDL decrease appeared to be mainly because of stimulation of LDLreceptor activity.
EAS16-0453, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. INCIDENCE OF CARDIOVASCULAR DISEASE AMONG INDIVIDUALS WITH AND WITHOUT FAMILIAL HYPERCHOLESTEROLEMIA ATTENDING A LIPID CLINIC
EAS16-0671, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. PREVALENCE OF DYSLIPIDAEMIA AMONG ADULTS AGED 50e64 YEARS IN IRELAND: THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)
F. Barkas, E. Klouras, T. Dimitriou, G. Liamis, M. Elisaf, E. Liberopoulos. School of Medicine - University of Ioannina, Internal Medicine, Ioannina, Greece Objectives: Familial hypercholesterolemia (FH) is associated with premature coronary heart disease (CHD), while controversial data exist regarding non-coronary cardiovascular diseases. We aimed to compare the incidence of cardiovascular disease between patients with FH and non-FH individuals. Methods: This was an observational study including adults followed-up for 3 years at a single lipid clinic. The diagnosis of FH was made according to the Dutch Lipid Clinic Network Criteria. We compared the rates of CHD, ischemic stroke and peripheral arterial disease (PAD) between FH and nonFH individuals at the most recent visit, after adjusting for the effects of variables associated with the risk of cardiovascular disease (metabolic syndrome, diabetes, hypertension, family history of premature cardiovascular disease, smoking, age and low-density lipoprotein cholesterol levels at the most recent visit). Results: One thousand subjects were studied; of those, 120 were diagnosed with FH (possible, probable or definite). Mean follow-up was 7 years. A higher incidence of CHD was noticed in subjects with FH compared with than non-FH individuals (16.7 vs 9.0%, adjusted p <0.05). No significant differences were found between 2 groups regarding the incidence of ischemic stroke (9.2 vs 10.7%) and PAD (5.6 vs 4.7%). Conclusions: FH is associated with a higher risk of CHD but not of stroke and PAD.
EAS16-0061, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. CHANGES IN PLASMA LIPOPROTEIN SUBFRACTIONS IN PATIENTS WITH POLYGENIC HYPERCHOLESTEROLEMIA, FAMILIAL COMBINED HYPERLIPOPROTEINEMIA, AND FAMILIAL HYPERCHOLESTEROLEMIA AFTER ATORVASTATIN B. Muinjonov 1, E. Giyazitdinova 2. 1 Tashkent, Uzbekistan; Medical Academy, Neurology, Tashkent, Uzbekistan
2
C. Murphy 1, E. Shelley 2, T. Fahey 3, R.A. Kenny 1. 1 Trinity College Dublin, TILDA Medical Gerontology, Dublin, Ireland; 2 Health Service Executive, Department of Public Health, Dublin, Ireland; 3 Royal College of Surgeons Medical School, Department of General Practice HRB Centre for Primary Care Research, Dublin, Ireland Objectives: Dyslipidaemia is an important modifiable risk factor for cardiovascular disease (CVD). The aim of this study was to provide an estimate of dyslipidaemia in a cohort of adults in Ireland. Methods: The study is cross-sectional in design using interview and health assessment data from the baseline wave (2009-2011) of TILDA. Non-fasting venous blood was drawn for lipid profiling. CVD risk was calculated using self-reported morbidity data and Systematic COronary Risk Evaluation (SCORE). Dyslipidaemia was defined as the use of lipid lowering medication and/or elevated total cholesterol (TC) or elevated low-density lipoprotein cholesterol (LDL-C) above threshold European Society of Cardiology guidelines and according to CVD risk categorization. Results: Overall 3343 individuals (1835 women and 1508 men) were included. Almost 5% were categorized as requiring secondary prevention, 8.3% as high risk for CVD, 49.4% as moderate risk and 19.5% as low risk. Mean TC was 5.4 mmol/L (SD 0.9) in women and 5.0 mmol/L (SD 0.9) in men. Mean LDL-C was 3.1 mmol/L (SD 0.8) in women and 2.9 mmol/L (SD 0.9) in men. Lipid lowering medication was used by 26.6% (95% CI 25.1%28.1%). Dyslipidaemia prevalence was 82.4% (95% CI 81.1%-83.7%), ranging from 94.5% (95% CI 91.0%-98.0%) in the secondary prevention group to 78.8% (95% CI 76.6%-81.1%) in those at low risk for CVD. Conclusions: This study provides a comprehensive estimate of dyslipidaemia prevalence among adults in Ireland and provides evidence for policy, particularly in primary care as a large proportion of the population remain exposed to this known and modifiable risk factor.
EAS16-0707, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. IMPACT OF SOCIAL AND CLINICAL PARAMETERS ON NON-HDL CHOLESTEROL IN SCHOOL CHILDREN
Tashkent
Objectives: We compared the effects of atorvastatin on 3 LDL subfractions, and their associations with LDL-receptor activities, in Japanese patients with polygenic hypercholesterolemia (PHC), familial combined hyperlipoproteinemia (FCHL), and familial hypercholesterolemia (FH). Methods: Atorvastatin was administered to patients with PHC (n ¼ 11), FCHL (n ¼ 16), and FH (n ¼ 13). We measured plasma levels of lipids, remnant-like particle cholesterol, apoproteins, and cholesterol in lipoprotein fractions. Sequential ultracentrifugation was performed to subfractionate the plasma lipoproteins, and lymphocyte LDL-receptor activities were estimated using flow cytometry. Results: The average daily dosage of atorvastatin was 10, 27, and 40 mg in patients with PHC, FCHL, and FH, respectively; after 12 months of
A. Pereira 1, F. Guarnieri 2, A.P.Q. Mello 3, R. Santos Filho 4, T.L.R. Martinez 4. 1 HCFMUSP, Cardiology, Sao Paulo, Brazil; 2 IESP/UERJ, Political Studies, Rio de Janeiro, Brazil; 3 LATINMED, Nutrition, Sao Paulo, Brazil; 4 ~ Sao Paulo Heart Institute - InCor, Lipid Clinic, Sao Paulo, Brazil Objectives: All conditions that present correlation with the major risk factors for Cardiovascular Disease(CVD) must be researched so as to facilitate the proposals for intervention. The aim is to evaluate the impact of social, family, biochemical and clinical data on Non HDL-c(NHDL-c) in schoolchildren. Methods: 500 schoolchildren, ages 6 to 14yr old, had their NHDL-c studied by Multivariate Linear Regression as to their correlation coefficients to 20 factors, among them, p ex: BMI, arterial blood pressure, parents
e45
treatment compared with non-FH subjects (64 vs 28% and 62 vs 19%, p <0.05, respectively). Among those at high cardiovascular risk, both the FH and non-FH subjects achieved similar rates of LDL-C goal achievement (37 vs 44%, p¼NS). Among those at very high risk, those with FH were less likely to achieve levels of LDL-C <70 mg/dL compared with non-FH (15 vs 25%, p <0.05). Conclusions: A higher proportion of patients with FH receives a high-intensity statin or combination of lipid-lowering drugs compared with the non-FH individuals in a lipid clinic. Nevertheless, not all the individuals with FH either receive high-intensity statin ± ezetimibe or achieve optimal LDL-C levels.
atorvastatin treatment, LDL cholesterol (LDL-C) plasma levels decreased by 44%, 50%, and 53%, respectively (all, P < .0001). Atorvastatin reduced lowdensity LDL-C plasma levels in patients with PHC (48% reduction), FCHL (53%), and FH (46%) (all, P < .0001). Plasma levels of medium-density and high-density LDL-C were also significantly reduced in the 3 patient groups (all, P .0147). LDL-receptor activity was negatively correlated with baseline levels of medium-density LDL-C and with the decreases in plasma md-LDL-C levels. Conclusions: Atorvastatin decreased the levels of the 3 LDL fractions. The md-LDL decrease appeared to be mainly because of stimulation of LDLreceptor activity.
EAS16-0453, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. INCIDENCE OF CARDIOVASCULAR DISEASE AMONG INDIVIDUALS WITH AND WITHOUT FAMILIAL HYPERCHOLESTEROLEMIA ATTENDING A LIPID CLINIC
EAS16-0671, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. PREVALENCE OF DYSLIPIDAEMIA AMONG ADULTS AGED 50e64 YEARS IN IRELAND: THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)
F. Barkas, E. Klouras, T. Dimitriou, G. Liamis, M. Elisaf, E. Liberopoulos. School of Medicine - University of Ioannina, Internal Medicine, Ioannina, Greece Objectives: Familial hypercholesterolemia (FH) is associated with premature coronary heart disease (CHD), while controversial data exist regarding non-coronary cardiovascular diseases. We aimed to compare the incidence of cardiovascular disease between patients with FH and non-FH individuals. Methods: This was an observational study including adults followed-up for 3 years at a single lipid clinic. The diagnosis of FH was made according to the Dutch Lipid Clinic Network Criteria. We compared the rates of CHD, ischemic stroke and peripheral arterial disease (PAD) between FH and nonFH individuals at the most recent visit, after adjusting for the effects of variables associated with the risk of cardiovascular disease (metabolic syndrome, diabetes, hypertension, family history of premature cardiovascular disease, smoking, age and low-density lipoprotein cholesterol levels at the most recent visit). Results: One thousand subjects were studied; of those, 120 were diagnosed with FH (possible, probable or definite). Mean follow-up was 7 years. A higher incidence of CHD was noticed in subjects with FH compared with than non-FH individuals (16.7 vs 9.0%, adjusted p <0.05). No significant differences were found between 2 groups regarding the incidence of ischemic stroke (9.2 vs 10.7%) and PAD (5.6 vs 4.7%). Conclusions: FH is associated with a higher risk of CHD but not of stroke and PAD.
EAS16-0061, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. CHANGES IN PLASMA LIPOPROTEIN SUBFRACTIONS IN PATIENTS WITH POLYGENIC HYPERCHOLESTEROLEMIA, FAMILIAL COMBINED HYPERLIPOPROTEINEMIA, AND FAMILIAL HYPERCHOLESTEROLEMIA AFTER ATORVASTATIN B. Muinjonov 1, E. Giyazitdinova 2. 1 Tashkent, Uzbekistan; Medical Academy, Neurology, Tashkent, Uzbekistan
2
C. Murphy 1, E. Shelley 2, T. Fahey 3, R.A. Kenny 1. 1 Trinity College Dublin, TILDA Medical Gerontology, Dublin, Ireland; 2 Health Service Executive, Department of Public Health, Dublin, Ireland; 3 Royal College of Surgeons Medical School, Department of General Practice HRB Centre for Primary Care Research, Dublin, Ireland Objectives: Dyslipidaemia is an important modifiable risk factor for cardiovascular disease (CVD). The aim of this study was to provide an estimate of dyslipidaemia in a cohort of adults in Ireland. Methods: The study is cross-sectional in design using interview and health assessment data from the baseline wave (2009-2011) of TILDA. Non-fasting venous blood was drawn for lipid profiling. CVD risk was calculated using self-reported morbidity data and Systematic COronary Risk Evaluation (SCORE). Dyslipidaemia was defined as the use of lipid lowering medication and/or elevated total cholesterol (TC) or elevated low-density lipoprotein cholesterol (LDL-C) above threshold European Society of Cardiology guidelines and according to CVD risk categorization. Results: Overall 3343 individuals (1835 women and 1508 men) were included. Almost 5% were categorized as requiring secondary prevention, 8.3% as high risk for CVD, 49.4% as moderate risk and 19.5% as low risk. Mean TC was 5.4 mmol/L (SD 0.9) in women and 5.0 mmol/L (SD 0.9) in men. Mean LDL-C was 3.1 mmol/L (SD 0.8) in women and 2.9 mmol/L (SD 0.9) in men. Lipid lowering medication was used by 26.6% (95% CI 25.1%28.1%). Dyslipidaemia prevalence was 82.4% (95% CI 81.1%-83.7%), ranging from 94.5% (95% CI 91.0%-98.0%) in the secondary prevention group to 78.8% (95% CI 76.6%-81.1%) in those at low risk for CVD. Conclusions: This study provides a comprehensive estimate of dyslipidaemia prevalence among adults in Ireland and provides evidence for policy, particularly in primary care as a large proportion of the population remain exposed to this known and modifiable risk factor.
EAS16-0707, DYSLIPIDEMIAS: DYSLIPIDEMIAS, SCREENING AND TREATMENT. IMPACT OF SOCIAL AND CLINICAL PARAMETERS ON NON-HDL CHOLESTEROL IN SCHOOL CHILDREN
Tashkent
Objectives: We compared the effects of atorvastatin on 3 LDL subfractions, and their associations with LDL-receptor activities, in Japanese patients with polygenic hypercholesterolemia (PHC), familial combined hyperlipoproteinemia (FCHL), and familial hypercholesterolemia (FH). Methods: Atorvastatin was administered to patients with PHC (n ¼ 11), FCHL (n ¼ 16), and FH (n ¼ 13). We measured plasma levels of lipids, remnant-like particle cholesterol, apoproteins, and cholesterol in lipoprotein fractions. Sequential ultracentrifugation was performed to subfractionate the plasma lipoproteins, and lymphocyte LDL-receptor activities were estimated using flow cytometry. Results: The average daily dosage of atorvastatin was 10, 27, and 40 mg in patients with PHC, FCHL, and FH, respectively; after 12 months of
A. Pereira 1, F. Guarnieri 2, A.P.Q. Mello 3, R. Santos Filho 4, T.L.R. Martinez 4. 1 HCFMUSP, Cardiology, Sao Paulo, Brazil; 2 IESP/UERJ, Political Studies, Rio de Janeiro, Brazil; 3 LATINMED, Nutrition, Sao Paulo, Brazil; 4 ~ Sao Paulo Heart Institute - InCor, Lipid Clinic, Sao Paulo, Brazil Objectives: All conditions that present correlation with the major risk factors for Cardiovascular Disease(CVD) must be researched so as to facilitate the proposals for intervention. The aim is to evaluate the impact of social, family, biochemical and clinical data on Non HDL-c(NHDL-c) in schoolchildren. Methods: 500 schoolchildren, ages 6 to 14yr old, had their NHDL-c studied by Multivariate Linear Regression as to their correlation coefficients to 20 factors, among them, p ex: BMI, arterial blood pressure, parents