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The Prevalence of Familial Hypercholesterolemia (FH) in Chinese Patients With Acute Myocardial Infarction (AMI): Data
Hui-Wei Shi1, Jin-Gang Yang1, Yang Wang2
1Endocrinology and Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Familial hypercholesterolemia (FH) affects 4.2% of Chinese patients experiencing acute myocardial infarction (AMI). FH patients were younger at AMI onset but showed no difference in clinical severity compared to non-FH patients.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Familial hypercholesterolemia (FH) is a genetic disorder.
- Its prevalence among Chinese patients with acute myocardial infarction (AMI) is not well-established.
- Understanding FH prevalence is crucial for cardiovascular risk stratification.
Purpose of the Study:
- To determine the prevalence of heterozygous familial hypercholesterolemia (HeFH) in Chinese patients with first-onset AMI.
- To compare the clinical characteristics and age of onset of AMI between HeFH and non-HeFH patients.
Main Methods:
- The China Acute Myocardial Infarction (CAMI) Registry enrolled 13,002 statin-naïve patients aged 18-80 with first-onset AMI.
- Patients were classified as definite/probable HeFH, possible HeFH, or non-HeFH using the Dutch Lipid Clinical Network Criteria (DLCNC).
- Clinical data, including age of onset and severity markers, were analyzed.
Main Results:
- The overall prevalence of HeFH among Chinese AMI patients was 4.2% (0.47% definite/probable, 3.73% possible).
- HeFH patients were significantly younger at AMI onset (54-56 years) compared to non-HeFH patients (63 years).
- No significant differences were observed in clinical severity, such as Killip class, cardiac arrest, or TIMI grade post-PCI, between HeFH and non-HeFH groups.
Conclusions:
- The prevalence of HeFH in Chinese patients with AMI is 4.2%.
- Younger age at AMI onset is a key characteristic of FH patients.
- Despite younger onset, FH does not appear to influence the immediate clinical severity of AMI in this cohort.
Abstract:
Background: The prevalence of familial hypercholesterolemia (FH) in the patients with acute myocardial infarction (AMI) in China is unclear. Materials and Methods: In China Acute Myocardial Infarction (CAMI) Registry, 13,002 patients with age 18-80 were consecutively enrolled with first-onset AMI who were naïve to statin before admission from January 1st, 2013 to October 31st, 2014. According to Dutch Lipid Clinical Network Criteria (DLCNC), the patients were divided to heterozygous familial hypercholesterolemia (HeFH) (definite/probable HeFH, possible HeFH) or non-HeFH group. Results: The number of the patients in the three groups was as following, 62 in definite/probable HeFH group, 484 in possible HeFH group, 12,456 in non-HeFH group. The prevalence of HeFH is 4.2% (including 0.47% of definite/probable HeFH, 3.73% of possible FH). The average age of onset of first-time AMI was 54 ± 12, 56 ± 12, 63 ± 12 years old (p < 0.0001) in definite/probable HeFH group, possible HeFH group and non-HeFH group, respectively. The percentage of Killip III or above (8.1 vs. 4.3 vs. 6.3%, p = 0.1629), cardiac arrest (1.6 vs. 0.6 vs. 0.9%, p = 0.6990), and TIMI 0-2 grade after primary percutaneous cardiac intervention (PCI) (0 vs. 6.8 vs. 4.3%, p = 0.5866) was not significantly different in definite/probable HeFH group, possible HeFH group and non-HeFH group, respectively. Conclusions: The prevalence of HeFH in Chinese patients with AMI is 4.2%. The patients were significantly younger in HeFH group, when compared with those with non-HeFH. However, no significant differences were found in the severity of clinical manifestations in both HeFH and non-HeFH group.
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