1. Familial hypercholesterolemia in Mexico: Initial insights from the national registry
- Author
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Aldo Ferreira-Hermosillo, Alejandra Vázquez-Cárdenas, Humberto Alvarez-Lopez, Ursulo Juarez-Herrera, Ashanty Flores-Ortega, Guadalupe Jiménez-Domínguez, Juan C Garnica-Cuellar, Jesus R Holguin-Almada, Eloy A Zepeda-Carrillo, Alexandro J. Martagón, Berenice Peña-Aparicio, Alma B Medrano-Rodriguez, Luis E. Simental-Mendía, Berenice Garcia-Guzman, Laura E Garcia de Leon, Roberto Contreras-Chacon, Luis E Vera-Arroyo, Ricardo Allende-Carrera, Jose A Alvarez, Cristina Martinez-Sibaja, Anell Hernandez-Garcia, Laura G Gomez-Herrera, Victoria Mendoza-Zubieta, Fabiola Lugo-Sobrevilla, Ma. Ludivina Robles-Osorio, Gustavo Gonzalez-Retana, Eduardo Marquez-Rodriguez, Jose J Ceballos-Macías, Francisco G Padilla, Jose C Amezcua-Martinez, Daniel I Perez-Vazquez, Arsenio Vargas-Vázquez, Elizabeth Ramirez-Cooremans, Manuel O De Los Rios-Ibarra, Jose J Garduño-Garcia, Bethsabel Rodríguez-Encinas, Karina J Acevedo-Rivera, Manuel de Los Reyes Barrera-Bustillo, Luis A Valdez-Talavera, Humberto García-Aguilar, Ruy D Arjona-Villicaña, Daniel Elías-López, Hector Garcia-Alcala, Margarita Torres-Tamayo, Juan Rosas-Saucedo, Ramon Madriz-Prado, Perla A Carrillo-Gonzalez, Julieta D Morales-Portano, Carlos A. Aguilar-Salinas, Neftali Eduardo Antonio-Villa, Mario H Figueroa-Andrade, Roopa Mehta, Carla V Mendez-Valencia, Alinna Y Ruiz-Garcia, Eduardo A Reyes-Rodriguez, Jose R Gomez-Cruz, Jose C Morales-Oyervides, Gabriela A. Galan Ramirez, Rocio Martinez-Alvarado, Leobardo Sauque-Reyna, Gonzalo Carazo-Vargas, Jesus R Gonzalez-Gonzalez, Hector E Arriaga-Cazares, Alejandro Romero-Zazueta, and Nacu Caracas-Portilla
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Type 2 diabetes ,Familial hypercholesterolemia ,030204 cardiovascular system & hematology ,Hyperlipoproteinemia Type II ,03 medical and health sciences ,0302 clinical medicine ,Ezetimibe ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Tendon xanthomas ,Male gender ,Genetic testing ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,European atherosclerosis society ,National registry ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Familial hypercholesterolemia (FH) remains underdiagnosed and undertreated.Report the results of the first years (2017-2019) of the Mexican FH registry.There are 60 investigators, representing 28 federal states, participating in the registry. The variables included are in accordance with the European Atherosclerosis Society (EAS) FH recommendations.To date, 709 patients have been registered, only 336 patients with complete data fields are presented. The mean age is 50 (36-62) years and the average time since diagnosis is 4 (IQR: 2-16) years. Genetic testing is recorded in 26.9%. Tendon xanthomas are present in 43.2%. The prevalence of type 2 diabetes is 11.3% and that of premature CAD is 9.8%. Index cases, male gender, hypertension and smoking were associated with premature CAD. The median lipoprotein (a) level is 30.5 (IQR 10.8-80.7) mg/dl. Statins and co-administration with ezetimibe were recorded in 88.1% and 35.7% respectively. A combined treatment target (50% reduction in LDL-C and an LDL-C100 mg/dl) was achieved by 13.7%. Associated factors were index case (OR 3.6, 95%CI 1.69-8.73, P = .002), combination therapy (OR 2.4, 95%CI 1.23-4.90, P = .011), type 2 diabetes (OR 2.8, 95%CI 1.03-7.59, P = .036) and age (OR 1.023, 95%CI 1.01-1.05, P = .033).The results confirm late diagnosis, a lower than expected prevalence and risk of ASCVD, a higher than expected prevalence of type 2 diabetes and undertreatment, with relatively few patients reaching goals. Recommendations include, the use of combination lipid lowering therapy, control of comorbid conditions and more frequent genetic testing in the future.
- Published
- 2021
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