Familial hypercholesterolemia screening program in Bosnia and Herzegovina and cardiovascular morbidity

Area of Science:

• Cardiology
• Genetics
• Public Health

Background:

• Familial hypercholesterolemia (FH) is a genetic disorder leading to high LDL cholesterol.
• Cardiovascular diseases (CVDs) are a major concern in FH patients.
• Estimating FH prevalence and associated CVDs in Bosnia and Herzegovina is crucial for public health strategies.

Purpose of the Study:

• To determine the frequency of cardiovascular diseases (CVDs) in patients with familial hypercholesterolemia (FH) in Bosnia and Herzegovina.
• To analyze the association between FH severity (definite, probable, possible, unlikely) and the occurrence of coronary artery disease (CAD), premature CAD (PCAD), and cerebral vascular disease (CVD).

Main Methods:

• Lipid profiles of 307 patients with LDL > 4.5 mmol/L were screened between March 2008 and November 2016.
• FH diagnosis was based on the Dutch Lipid Clinic Network (DLCN) criteria, categorizing patients into four groups.
• Coronary artery disease (CAD), premature CAD (PCAD), and cerebral vascular disease (CVD) were assessed in each group.

Main Results:

• A total of 307 patients were analyzed, categorized into definite (Group 1, n=16), probable (Group 2, n=56), possible (Group 3, n=140), and unlikely (Group 4, n=95) FH.
• CAD and PCAD were significantly more prevalent in definite and probable FH groups (Groups 1 and 2) compared to Group 4.
• Cerebral vascular disease (CVD) showed a significant difference, being higher in the unlikely FH group (Group 4) compared to the definite, probable, and possible FH groups.

Conclusions:

• Definite and possible FH are strongly associated with coronary artery disease (CAD) and premature CAD (PCAD).
• Cerebral vascular disease (CVD) is significantly more prevalent in individuals with unlikely FH.
• Enhanced screening programs and global information exchange are vital for increasing awareness and understanding of FH prevalence and its associated risks.