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Intima-media thickness in treated and untreated patients with and without familial hypercholesterolemia: A systematic

Kika van Bergen En Henegouwen1, Barbara A Hutten2, Ilse K Luirink1

  • 1Departments of Pediatrics; Epidemiology and Data Science, Amsterdam UMC Location AMC, Amsterdam.

Journal of Clinical Lipidology
|February 21, 2022
PubMed

Insights

Familial hypercholesterolemia (FH) patients show increased intima-media thickness (IMT) compared to controls. Early and effective treatment in FH patients significantly reduces this difference, lowering cardiovascular risk.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Medical Imaging

Background:

  • Familial hypercholesterolemia (FH) is a genetic disorder causing high cholesterol and premature atherosclerosis.
  • Intima-media thickness (IMT) measured by ultrasound quantifies atherosclerosis in large arteries.
  • Assessing IMT differences in FH patients is crucial for understanding disease progression and treatment efficacy.

Purpose of the Study:

  • To compare intima-media thickness (IMT) in treated and untreated Familial hypercholesterolemia (FH) patients versus controls.
  • To analyze the age-related progression of IMT in FH patients.
  • To evaluate the impact of treatment on atherosclerosis progression in FH.

Main Methods:

  • Systematic literature search of MEDLINE, EMBASE, and Trials.gov up to April 2020.
  • Inclusion of 42 studies with 6,143 participants for meta-analysis.
  • Comparison of carotid and femoral IMT between FH patients (treated/untreated) and controls, analyzed by age.

Main Results:

  • FH patients exhibited significantly higher carotid IMT (0.11 mm) and femoral IMT (0.47 mm) versus controls.
  • Treated FH patients showed a smaller carotid IMT difference (0.05 mm) compared to untreated FH patients (0.12 mm) versus controls.
  • The age-related increase in carotid IMT was significantly lower in treated FH patients (0.0023 mm/year) than in untreated FH patients (0.0104 mm/year) versus controls.

Conclusions:

  • Familial hypercholesterolemia (FH) is associated with accelerated atherosclerosis, evidenced by increased IMT.
  • Early and effective treatment in FH patients significantly mitigates IMT progression.
  • Initiating robust treatment earlier and achieving treatment targets is vital for reducing cardiovascular risk in FH patients.

Keywords:
AtherosclerosisCholesterolDyslipidemiasFamilial hypercholesterolemiaHyperlipidemiaIntima-media thicknessLipid modifying drugsStatinsUltrasound

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