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Screening and treatment of Familial Hypercholesterolemia in a French sample of ambulatory care: A retrospective longitudinal cohort study
Archives of Cardiovascular Disease Supplements (2020) 12, 155—161
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09—Prevention—Epidemiology—Nutrition Saturday, January 18th, 2020 029
Screening and treatment of Familial Hypercholesterolemia in a French sample of ambulatory care: A retrospective longitudinal cohort study J. Ferrières 1,∗ , V. Banks 2 , D. Pillas 2 , L. Ricci 3 , M. Dova-Boivin 3 , J.V. Chauny 3 , G. Desamericq 3 1 Cardiologie B, Fédération de Cardiologie CHU Rangueil Toulouse, Toulouse, France 2 Amgen Ltd, Uxbridge, Royaume-Uni 3 Amgen SAS, Boulogne-Billancourt, France ∗ Corresponding author. E-mail address: [email protected] (J. Ferrières) Background Familial hypercholesterolemia (FH) is underdiagnosed, physicians from an electronic medical record (EMRs) were alerted to LDL-C levels > 190 mg/dL and invited to complete the Dutch Lipid Clinic Network score (DLCN). Purpose Describe characteristics, comorbidities and clinical management of patients diagnosed with definite or probable FH in an ambulatory care setting. Methods All patients with a DLCN score of definite/probable FH (score higher or equal than 6) between January 2016 and September 2018 were identified in the THIN® database (The Health Improvement Network; an anonymized EMR powered by GERSDATA, a Cegedim Health Data Division). These fully anonymized data were collected by 2000 General Practitioners, 130 cardiologists and 40 endocrinologists, receiving 5.5 million patients regularly in their office. Results From 999 anonymous patients with a DLCN score, 98 (10%) FH patients were identified (38 [39%] definite FH, 60 [61%] probable FH), 9 (9%) of whom already had genetic testing. Mean (SD) age was 57.4 (14.3) years; 56 (57%) patients were female, half (51/98 [52%]) were diagnosed with pure hypercholesterolemia (ICD10 code: E78.0) and 9 (9%) had a history of CV event. Sixty patients (61.2%) had LDL-C between 190 to 250 mg/dL and 16 (16.3%) had LDL-C higher than 250 mg/dL. At the time of DLCN assessment, one third (30/98 [31%]) of patients were not receiving any LLT, one third (34/98 [35%]) were receiving statins alone, 19% [19/98) receiving LLT combination with statin, and 15 (15%) other LLTs. Moderate statin intensity was prescribed in 20% (20/98) of patients;
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high intensity statin, 17%, (17/98); low intensity, 10% (10/98). No improvement on LLT use (including use of high statin intensity) was observed over the 12-month follow-up. Conclusion This is the first study in France that use EMR to screen possible FH patients. Our data highlight the need to screen, diagnosis and treat potential FH patients in ambulatory care settings. Disclosure of interest Amgen, Akcea, MSD, Sanofi, Servier. https://doi.org/10.1016/j.acvdsp.2019.09.320 300
Prevalence of hypertensive disorders during pregnancy and post-partum in France V. Olié 1,∗ , E. Moutengou 1 , C. Deneux-Tharaux 2,3 , S. Kretz 4 , A. Vallée 3,4 , J. Blacher 3,4 , V. Tsatsaris 5 , G. Plu-Bureau 2,6 1 Santé Publique France, Saint-Maurice 2 Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS) 3 Paris-Descartes university 4 Diagnosis and Therapeutic Center, Hôtel-Dieu; AP—HP; University Paris Descartes 5 Department of Obstetrics and Gynecology, AP—HP, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel-Dieu, Groupe Hospitalier Universitaire Ouest 6 Division of Gynaecology, AP—HP, Hôpital Cochin, Paris, France ∗ Corresponding author. E-mail address: [email protected] (V. Olié) Introduction Hypertensive disorders are one of the leading causes of maternal mortality and are also associated with significant cardiovascular and renal morbidity. However very few studies have evaluated the prevalence of different hypertensive disorders of pregnancy and postpartum in France. Purpose The aim of this nationwide study was to estimate the prevalence of hypertensives disorders during the pregnancy and the post-partum. Methods All women with a delivery after 22 weeks of amenorrhea between 2010 and 2016 were selected using data from the national hospital discharge database (PMSI-MCO) integrated into the national health data system (SNDS). In these women, chronic hypertension (persisting or not during pregnancy) in the year preceding pregnancy, gestational hypertension (occurring after 20 weeks of amenorrhea) and preeclampsia/eclampsia were recorded using
Available online at
ScienceDirect www.sciencedirect.com
09—Prevention—Epidemiology—Nutrition Saturday, January 18th, 2020 029
Screening and treatment of Familial Hypercholesterolemia in a French sample of ambulatory care: A retrospective longitudinal cohort study J. Ferrières 1,∗ , V. Banks 2 , D. Pillas 2 , L. Ricci 3 , M. Dova-Boivin 3 , J.V. Chauny 3 , G. Desamericq 3 1 Cardiologie B, Fédération de Cardiologie CHU Rangueil Toulouse, Toulouse, France 2 Amgen Ltd, Uxbridge, Royaume-Uni 3 Amgen SAS, Boulogne-Billancourt, France ∗ Corresponding author. E-mail address: [email protected] (J. Ferrières) Background Familial hypercholesterolemia (FH) is underdiagnosed, physicians from an electronic medical record (EMRs) were alerted to LDL-C levels > 190 mg/dL and invited to complete the Dutch Lipid Clinic Network score (DLCN). Purpose Describe characteristics, comorbidities and clinical management of patients diagnosed with definite or probable FH in an ambulatory care setting. Methods All patients with a DLCN score of definite/probable FH (score higher or equal than 6) between January 2016 and September 2018 were identified in the THIN® database (The Health Improvement Network; an anonymized EMR powered by GERSDATA, a Cegedim Health Data Division). These fully anonymized data were collected by 2000 General Practitioners, 130 cardiologists and 40 endocrinologists, receiving 5.5 million patients regularly in their office. Results From 999 anonymous patients with a DLCN score, 98 (10%) FH patients were identified (38 [39%] definite FH, 60 [61%] probable FH), 9 (9%) of whom already had genetic testing. Mean (SD) age was 57.4 (14.3) years; 56 (57%) patients were female, half (51/98 [52%]) were diagnosed with pure hypercholesterolemia (ICD10 code: E78.0) and 9 (9%) had a history of CV event. Sixty patients (61.2%) had LDL-C between 190 to 250 mg/dL and 16 (16.3%) had LDL-C higher than 250 mg/dL. At the time of DLCN assessment, one third (30/98 [31%]) of patients were not receiving any LLT, one third (34/98 [35%]) were receiving statins alone, 19% [19/98) receiving LLT combination with statin, and 15 (15%) other LLTs. Moderate statin intensity was prescribed in 20% (20/98) of patients;
1878-6480/
high intensity statin, 17%, (17/98); low intensity, 10% (10/98). No improvement on LLT use (including use of high statin intensity) was observed over the 12-month follow-up. Conclusion This is the first study in France that use EMR to screen possible FH patients. Our data highlight the need to screen, diagnosis and treat potential FH patients in ambulatory care settings. Disclosure of interest Amgen, Akcea, MSD, Sanofi, Servier. https://doi.org/10.1016/j.acvdsp.2019.09.320 300
Prevalence of hypertensive disorders during pregnancy and post-partum in France V. Olié 1,∗ , E. Moutengou 1 , C. Deneux-Tharaux 2,3 , S. Kretz 4 , A. Vallée 3,4 , J. Blacher 3,4 , V. Tsatsaris 5 , G. Plu-Bureau 2,6 1 Santé Publique France, Saint-Maurice 2 Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS) 3 Paris-Descartes university 4 Diagnosis and Therapeutic Center, Hôtel-Dieu; AP—HP; University Paris Descartes 5 Department of Obstetrics and Gynecology, AP—HP, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel-Dieu, Groupe Hospitalier Universitaire Ouest 6 Division of Gynaecology, AP—HP, Hôpital Cochin, Paris, France ∗ Corresponding author. E-mail address: [email protected] (V. Olié) Introduction Hypertensive disorders are one of the leading causes of maternal mortality and are also associated with significant cardiovascular and renal morbidity. However very few studies have evaluated the prevalence of different hypertensive disorders of pregnancy and postpartum in France. Purpose The aim of this nationwide study was to estimate the prevalence of hypertensives disorders during the pregnancy and the post-partum. Methods All women with a delivery after 22 weeks of amenorrhea between 2010 and 2016 were selected using data from the national hospital discharge database (PMSI-MCO) integrated into the national health data system (SNDS). In these women, chronic hypertension (persisting or not during pregnancy) in the year preceding pregnancy, gestational hypertension (occurring after 20 weeks of amenorrhea) and preeclampsia/eclampsia were recorded using