Attainment of LDL Cholesterol Treatment Goals in Children and Adolescents With Familial Hypercholesterolemia. The SAFEHEART Follow-up Registry
Por:
Saltijeral A, Pérez de Isla L, Alonso R, Muñiz O, Díaz-Díaz JL, Fuentes F, Mata N, de Andrés R, Díaz-Soto G, Pastor J, Pinilla JM, Zambón D, Pinto X, Badimón L, Mata P and SAFEHEART Investigators
Publicada:
1 jun 2017
Ahead of Print:
29 nov 2016
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Introduction and objectives: Little is known about the characteristics
of persons with familial hypercholesterolemia (FH) younger than 18
years, the lipid-lowering therapy used in these patients, and the lipid
goals reached in real life. Our aim was to evaluate the achievement of
low-density lipoprotein cholesterol (LDL-C) treatment goals in FH
patients younger than 18 years enrolled in a large national registry.
Methods: We analyzed patients younger than 18 years enrolled in a large
ongoing registry of molecularly-defined patients with FH in Spain. The
attainment of guideline-recommended plasma LDL-C goals at entry and
follow-up was analyzed in relation to the use of lipid-lowering therapy.
Results: We enrolled 392 individuals younger than 18 years. Of these,
217 were molecularly-diagnosed FH patients and had a complete follow-up.
The median follow-up time was 4.69 years (interquartile range, 2.48-6.38
years), 68.2% of FH patients were on statins, and 41.5% patients had
LDL-C < 130 mg/dL. Statin use was the only predictor of LDL-C goal
attainment.
Conclusions: This study shows that a high proportion of FH patients
younger than 18 years have high LDL-C levels and fail to achieve
recommended LDL-C targets. Statin use was the only independent predictor
of LDL-C goal achievement. No safety concerns were detected during
follow-up. These results indicate that many FH patients are not
adequately controlled and that there is still room for treatment
improvement. (C) 2016 Sociedad Espanola de Cardiologi a. Published by
Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Saltijeral A:
Sección de Cardiología, Hospital Universitario del Tajo, Universidad Alfonso X el Sabio, Aranjuez, Madrid, Spain.
Pérez de Isla L:
Servicio de Cardiología, Hospital Clínico San Carlos, Universidad Complutense de Madrid, IDISSC, Madrid, Spain
Alonso R:
Servicio de Medicina Interna, Clínica las Condes, Santiago de Chile, Chile
Muñiz O:
Servicio de Medicina Interna, Hospital Virgen del Rocío, Sevilla, Spain
Díaz-Díaz JL:
Servicio de Medicina Interna, Hospital Abente y Lago, A Coruña, Spain
Fuentes F:
Unidad de Lípidos y Aterosclerosis, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain
Mata N:
Departamento de Epidemiología, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
de Andrés R:
Servicio de Medicina Interna, Fundación Jiménez Díaz, Madrid, Spain
Díaz-Soto G:
Departamento de Endocrinología, Hospital Clínico, Valladolid, Spain
:
Servicio de Pediatría, Hospital General Universitario de Elche, Alicante, Spain
:
Centro de Salud San Miguel de Salinas, San Miguel de Salinas, Alicante, Spain
Zambón D:
Clínica de Lípidos, Servicio de Endocrinología, Hospital Clínic, Barcelona, Spain
Pinto X:
Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Badimón L:
Centro de Investigación Cardiovascular, Instituto Catalán de Ciencias Cardiovasculares, IIB-Sant Pau, Barcelona, Spain
Mata P:
Fundación Hipercolesterolemia Familiar, Madrid, Spain
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