Περίληψη:
Background: The 2019 European guidelines (ESC/EAS) for the treatment of
dyslipidaemias recommend more aggressive targets for low-density
lipoprotein cholesterol (LDL-C) in patients with familial
hypercholesterolemia (FH). Current lipid-lowering treatment is often
inadequate to achieve these targets.
Methods: Data from the HELLAS-FH registry were analysed to assess
achievement of LDL-C targets in adults with FH based on the 2019 ESC/EAS
guidelines. In patients who had not achieved LDL-C target, the maximally
reduced LDL-C value was calculated after theoretical switch to
rosuvastatin/ezetimibe 40/10 mg/day. The percentage of patients who
remained candidates for proprotein convertase subtilisin/kexin type 9
inhibitors (PCSK9i) was then calculated.
Results: Patients (n = 1694, mean age 50.8 +/- 14.7 years) had LDL-C
levels 242 +/- 71 mg/dL (6.3 +/- 1.8 mmol/L) at diagnosis. Most treated
patients were receiving statins (97.5%) and about half were on
additional ezetimibe (47.5%). Based on the 2019 ESC/EAS guidelines the
percentage of patients achieving LDL-C goals was only 2.7%. Following
theoretical up titration to rosuvastatin/ezetimibe 40/10 mg, LDL-C
target achievement rate would increase to 5.9%. In this scenario, most
patients (55.9%) would be eligible for PCSK9i treatment. Following
theoretical administration of a PCSK9i, LDL-C target achievement rate
would rise to 57.6%. However, 42.4% of patients would still be
eligible for further LDL-C lowering treatment.
Conclusions: Most FH patients do not reach new LDL-C targets even if on
maximum intensity statin/ezetimibe treatment. In this case, more than
half of FH patients are candidates for PCSK9i therapy and a considerable
proportion may still require additional LDL-C lowering.
Συγγραφείς:
Rizos, Christos V.
Skoumas, Ioannis
Rallidis, Loukianos and
Skalidis, Emmanouil
Tziomalos, Konstantinos
Garoufi, Anastasia
and Anagnostis, Panagiotis
Sfikas, George
Kotsis, Vasileios and
Doumas, Michalis
Kolovou, Genovefa
Lambadiari, Vaia
Dima,
Ioanna
Kiouri, Estela
Zacharis, Evangelos
Agapakis,
Dimitrios
Attilakos, Achilleas
Antza, Christina and
Vlachopoulos, Charalambos
Liberopoulos, Evangelos N.
