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Published on: September 15, 2018
Identification of familial hypercholesterolemia in patients with myocardial infarction: A Chinese cohort study
Sha Li1, Yan Zhang1, Cheng-Gang Zhu1
1Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Insights
Familial hypercholesterolemia (FH) significantly increases the risk of premature myocardial infarction (MI) in Chinese patients. Individuals with FH experienced earlier onset of MI, highlighting the condition's impact on cardiovascular health.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Familial hypercholesterolemia (FH) is characterized by elevated plasma cholesterol levels, significantly increasing the risk of premature cardiovascular disease.
- The prevalence and impact of FH, particularly in relation to myocardial infarction (MI), are increasingly recognized globally.
Purpose of the Study:
- To investigate the prevalence and clinical characteristics of FH in Chinese patients who have experienced a first myocardial infarction (MI).
- To determine the association between FH and the risk of early-onset MI in this population.
Main Methods:
- A cohort of 1843 consecutive patients with their first MI underwent coronary angiography.
- Clinical diagnosis of FH was established using the Dutch Lipid Clinic Network criteria.
- The study analyzed the prevalence of FH, its clinical features, and its relationship to early MI risk, independent of traditional risk factors.
Main Results:
- Premature MI (pMI) was observed in 48.2% of patients.
- The prevalence of definite/probable FH was 3.9% overall, significantly higher (7.1%) in the pMI group compared to the non-pMI group (0.9%).
- FH was associated with a significantly elevated risk of pMI (OR 5.05 for definite/probable FH) and an earlier age of MI onset (approximately 10 years younger in FH patients).
Conclusions:
- FH is a common condition among Chinese patients with MI, especially those experiencing premature MI.
- Phenotypic FH is a significant contributing factor to the early onset of myocardial infarction in the Chinese population.
Background:
Familial hypercholesterolemia (FH) is marked by an elevated plasma cholesterol and risk of premature cardiovascular disease. An increased burden of FH is being realized.
Objective:
To provide data on FH in Chinese patients with myocardial infarction (MI) and its potential contribution to early MI.
Methods:
A total of 1843 consecutive patients undergoing coronary angiography with their first MI were recruited. The clinical FH was diagnosed using the Dutch Lipid Clinic Network criteria. The prevalence and clinical features of FH and the relationship of FH to risk of early MI were investigated.
Results:
Of the 1843 patients, 48.2% were detected as premature MI (pMI, the onset age ≤55 years for men, ≤60 years for women). The prevalence of definite/probable FH reached 3.9% (7.1% in pMI and 0.9% in non-pMI). Furthermore, we found that the risk of pMI was significantly elevated in both definite/probable FH (vs. unlikely FH, odds ratio, 5.05 [1.10-23.23]) and possible FH (vs unlikely FH, odds ratio, 2.65 [1.22-5.77]), independently from classical risk factors and medications. Additionally, patients with definite/probable FH occurred 10 years younger than those with unlikely FH in the onset age of MI (48.63 ± 1.20 vs 58.35 ± 0.30 years, P < .001). When considered in subgroup of pMI or non-pMI, an early onset of MI was also observed in definite/probable FH (pMI, 45.83 ± 0.89 vs 47.87 ± 0.34 years; non-pMI, 60.75 ± 1.96 vs 65.07 ± 0.22 years; both P < .05).
Conclusion:
The prevalence of FH among Chinese patients with MI appeared common, particularly among those with pMI. The phenotypic FH might significantly promote the early onset of MI.
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