Familial hypercholesterolaemia present in 1 of 10 patients with MI at young age
About one of 10 patients with myocardial infarction (MI) at a young age present with clinically defined familial hypercholesterolaemia (FH), reports a study. Furthermore, only two-thirds of FH patients have been discharged on high-intensity statin therapy, and several present with elevated low-density lipoprotein cholesterol (LDL-C) at 1 year.
A total of 1,996 adults (median age, 45 years; 19 percent women; 54 percent had ST-segment elevation MI) were included. Of the 180 (9 percent) patients with probable/definite FH, 42.8 percent were not on statins prior to their MI.
There were 1,966 patients surviving until hospital discharge, among whom 89.4 percent of FH patients and 89.9 percent of non-FH patients were released on statin therapy (p=0.82). Of the FH patients, 63.3 percent were discharged on high-intensity statin relative to 48.4 percent of non-FH patients (p<0.001).
At 1-year follow-up, LDL-C reduction was –44.4 percent among FH patients compared with –34.5 percent in non-FH patients (p=0.006). In addition, there were more FH than non-FH patients with LDL-C ≥70 mg/dl (82.2 percent vs 64.5 percent; p<0.001).
“These findings reinforce the need for more aggressive lipid-lowering therapy in young FH and non-FH patients post-MI,” the authors said.
This retrospective cohort study sought to assess the prevalence of clinically defined FH and examine the rates of statin utilization and LDL-C achieved 1 year post-MI. Participants included patients who experienced an MI at or below age 50 years between 2000 and 2016 at two academic centres.
The Dutch Lipid Clinic criteria defined probable or definite FH. Outcomes were as follows: proportion of patients classified as probable or definite FH, use of lipid-lowering therapy, and LDL-C achieved 1 year post-MI.