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Prevalence of Severe Hypercholesterolemia and Familial Hypercholesterolemia Phenotype in Patients with Acute Coronary
Urtė Aliošaitienė1,2, Aleksandras Laucevičius3, Urtė Smailytė1
1Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania.
Insights
Severe hypercholesterolemia affects nearly 10% of patients hospitalized with acute coronary syndrome (ACS). This study highlights the significant prevalence of this condition, often linked to familial hypercholesterolemia, in ACS patients.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Atherosclerotic cardiovascular disease is a leading global cause of mortality and morbidity.
- Hypercholesterolemia is a known risk factor, but severe hypercholesterolemia, characteristic of familial hypercholesterolemia, is less studied.
- Acute coronary syndrome (ACS) is a critical manifestation of atherosclerotic cardiovascular disease.
Purpose of the Study:
- To determine the prevalence of severe hypercholesterolemia in patients presenting with acute coronary syndrome.
- To investigate the co-occurrence of other cardiovascular risk factors in this patient group.
Main Methods:
- Retrospective analysis of 34,669 patients hospitalized with ACS at Vilnius University Hospital Santaros Klinikos.
- Data collection included demographics, cardiovascular risk factors (hypertension, diabetes), and low-density lipoprotein cholesterol (LDL-C) levels.
- Severe hypercholesterolemia was defined as LDL-C levels ≥ 4.9 mmol/L.
Main Results:
- 9.9% of ACS patients (3434 individuals) exhibited severe hypercholesterolemia (LDL-C ≥ 4.9 mmol/L).
- Phenotypically probable familial hypercholesterolemia was identified in 1.1% and definite familial hypercholesterolemia in 0.1% of patients.
- Arterial hypertension was the most frequent co-occurring risk factor, present in 48% of the study population.
Conclusions:
- Severe hypercholesterolemia is a common finding in patients hospitalized with acute coronary syndrome, affecting nearly 10% of this population.
- While definite familial hypercholesterolemia is rare (0.1%), its presence underscores the need for early detection and management in ACS patients.
- The high prevalence of severe hypercholesterolemia in ACS patients emphasizes the importance of aggressive lipid management strategies.
Abstract:
Background and Objectives: Atherosclerotic cardiovascular disease is one of the most common causes of death and disability around the world. Hypercholesterolemia is an established and widely prevalent risk factor; however, the prevalence of severe hypercholesterolemia (which is characteristic for familial hypercholesterolemia) has been studied far less. The aim of this study was to determine the prevalence of severe hypercholesterolemia among patients with acute coronary syndrome. Materials and Methods: A retrospective study of patients hospitalised at Vilnius University Hospital Santaros Klinikos due to acute coronary syndrome was performed. Data were attained from an electronic medical history database. Data such as sex, age, cardiovascular risk factors (hypertension, diabetes) and low-density cholesterol results were collected. Severe hypercholesterolemia was defined as low-density lipoprotein cholesterol levels ≥ 4.9 mmol/L. Results: A total of 34,669 patients were included in this study (12,115 females (34.9%) and 22554 (65.1%) males, p < 0.001). The median age of the entire study population was 67 years. A total of 3434 patients (9.9%) had severe hypercholesterolemia, 371 (1.1%) patients met the criteria for phenotypically probable familial hypercholesterolemia, and 36 (0.1%) patients presented with phenotypically definite familial hypercholesterolemia. The most common concomitant risk factor in this study was arterial hypertension, which was found in 48% of patients. Conclusions: Based on the results of this study, severe hypercholesterolemia is prevalent among patients with acute coronary syndrome, with as many as 9.9% of patients presenting with severe hypercholesterolemia at the time of hospitalisation. The definite familial hypercholesterolemia phenotype is scarcer, with prevalence reaching 0.1% of patients with acute coronary syndrome.
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