Risk of Recurrent Coronary Events in Patients With Familial Hypercholesterolemia; A 10-Years Prospective Study

Area of Science:

• Cardiology
• Genetics
• Pharmacology

Background:

• Familial hypercholesterolemia (FH) requires long-term management.
• Real-world evidence on intensive lipid-lowering medication (LLM) and lifestyle interventions in FH is crucial.

Purpose of the Study:

• To evaluate the long-term effects of intensive LLM and optimized lifestyle in FH patients.
• To assess treatment outcomes and cardiovascular event rates in a real-world FH cohort.

Main Methods:

• Inclusion of 357 adults with FH (86.4% with FH-mutation) diagnosed in 2006.
• Follow-up of 279 patients after a median of 10 years, assessing lipid levels and cardiovascular events.
• Analysis of treatment patterns, including high-intensity statins and PCSK9 inhibitors, and their impact on LDL-C.

Main Results:

• Mean LDL-C decreased from 3.9 to 3.0 mmol/L. Women had higher LDL-C (3.3 mmol/L) than men (2.8 mmol/L).
• PCSK9 inhibitors reduced LDL-C to 2.0 mmol/L in 25 patients. 20.4% of patients had established ASCVD at baseline.
• 80.4% of patients with baseline ASCVD experienced a new event; 13.1% of those without ASCVD had a first-time event.

Conclusions:

• A mean LDL-C of 3.0 mmol/L is achievable in FH with intensive, specialized care.
• Women with FH exhibit higher LDL-C levels than men. Patients with established ASCVD remain at high risk for recurrent events.