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CT coronary plaque burden in asymptomatic patients with familial hypercholesterolaemia

Lisan A Neefjes1, Gert-Jan R Ten Kate, Alexia Rossi

  • 1Department of Radiology and Cardiology, Erasmus Medical Center Rotterdam, CA, Rotterdam, The Netherlands. l.neefjes@erasmusmc.nl

Heart (British Cardiac Society)
|May 14, 2011
PubMed

Insights

Asymptomatic patients with familial hypercholesterolaemia (FH) show higher coronary plaque burden despite statin treatment. Male FH patients achieving lower LDL cholesterol levels had reduced calcium scores and plaque burden.

Area of Science:

  • Cardiovascular Imaging
  • Medical Diagnostics
  • Pharmacological Research

Background:

  • Familial hypercholesterolaemia (FH) is a genetic disorder causing high LDL cholesterol and premature cardiovascular disease.
  • Early detection and management of atherosclerosis in FH patients are crucial.
  • The effectiveness of statin therapy on coronary plaque burden in asymptomatic FH patients requires further investigation.

Purpose of the Study:

  • To compare coronary plaque burden and calcium scores in asymptomatic FH patients versus controls using CT.
  • To evaluate the impact of statin treatment duration and efficacy on atherosclerosis in FH.

Main Methods:

  • 101 asymptomatic FH patients and 126 controls with non-anginal chest pain underwent CT calcium scoring and angiography.
  • FH patients had a history of 10 ± 8 years of statin treatment.
  • Coronary calcium score and plaque burden were quantified and compared between groups.

Main Results:

  • Patients with FH exhibited significantly higher total calcium scores (median 87 vs 7; p < 0.001) and plaque burden (p < 0.01).
  • Male FH patients with LDL cholesterol < 3.0 mmol/l on statins showed reduced coronary calcium (p < 0.01) and plaque burden (p = 0.02).

Conclusions:

  • Asymptomatic middle-aged FH patients have substantial coronary plaque burden despite intensive statin therapy.
  • Aggressive statin treatment may reduce, but not eliminate, atherosclerosis progression in FH.
  • CT imaging is valuable for assessing cardiovascular risk in FH patients.
Abstract

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