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Familial Hypercholesterolemia and Risk of Peripheral Arterial Disease and Chronic Kidney Disease.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2018 Dec 01; Vol. 103 (12), pp. 4491-4500. - Publication Year :
- 2018
-
Abstract
- Context: Individuals with familial hypercholesterolemia (FH) have a high risk of coronary artery disease, but their risk of peripheral arterial disease (PAD) and chronic kidney disease (CKD) is unknown.<br />Objective: In individuals with clinical FH, we tested the hypotheses (1) that the risks of PAD and CKD are elevated and (2) that low ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR) are associated with a high risk of myocardial infarction.<br />Design and Setting: Prospective cohort study of the general population.<br />Participants: A total of 106,172 individuals, of whom 7109 were diagnosed with FH.<br />Main Outcome Measures: PAD, CKD, and myocardial infarction.<br />Results: Compared with individuals with unlikely FH, multivariable adjusted ORs (95% CIs) of PAD were 1.84 (1.70 to 2.00) in those with possible FH and 1.36 (1.00 to 1.84) in individuals with probable/definite FH. For CKD, the corresponding ORs (95% CIs) were 1.92 (1.78 to 2.07) and 2.42 (1.86 to 3.26). Compared with individuals with unlikely FH and ABI >0.9, the multivariable adjusted hazard ratio (95% CI) of myocardial infarction was 4.60 (2.36 to 8.97) in those with possible/probable/definite FH and ABI ≤0.9. Compared with individuals with unlikely FH and eGFR ≥60 mL/min/1.73 m2, the corresponding value was 2.19 (1.71 to 2.82) in those with possible/probable/definite FH and eGFR <60 mL/min/1.73 m2.<br />Conclusions: Individuals with clinical FH have increased risks of PAD and CKD, and low ABI and eGFR are associated with high risk of myocardial infarction. Consequently, individuals with FH should be screened for PAD and CKD, and ABI and eGFR may be used as prognostic tools in the management and treatment of FH to identify those at very high risk of myocardial infarction.
- Subjects :
- Aged
Ankle Brachial Index statistics & numerical data
Cholesterol blood
Cross-Sectional Studies
Denmark epidemiology
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hyperlipoproteinemia Type II diagnosis
Hyperlipoproteinemia Type II metabolism
Male
Middle Aged
Myocardial Infarction blood
Myocardial Infarction etiology
Myocardial Infarction metabolism
Peripheral Arterial Disease blood
Peripheral Arterial Disease etiology
Peripheral Arterial Disease metabolism
Prevalence
Prospective Studies
Renal Insufficiency, Chronic blood
Renal Insufficiency, Chronic etiology
Renal Insufficiency, Chronic metabolism
Risk Factors
Hyperlipoproteinemia Type II complications
Myocardial Infarction epidemiology
Peripheral Arterial Disease epidemiology
Renal Insufficiency, Chronic epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 103
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 30085243
- Full Text :
- https://doi.org/10.1210/jc.2018-01058