Low-density lipoprotein cholesterol goal achievement in patients with familial hypercholesterolemia in countries outside Western Europe: The International ChoLesterol management Practice Study

Santos, Raul D./0000-0002-9860-6582; Al-Rasadi, Khalid/0000-0003-0460-1236
WOS: 000488415700012
PubMed: 31208705
BACKGROUND: the cross-sectional observational International ChoLesterol management Practice Study study assessed achievement of European Society of Cardiology/European Atherosclerosis Society low-density lipoprotein cholesterol (LDL-C) targets in patients outside Western Europe. OBJECTIVE: the aim of the study was to assess LDL-C goal achievement in International ChoLesterol management Practice Study participants with familial hypercholesterolemia (FH). METHODS: A total of 334 patients (aged >= 18 years) with definite or probable FH (Dutch Lipid Clinic Network score >= 6; 43.1% genetically confirmed) who had been receiving stable lipid modifying therapy (LMT) for >= 3 months were enrolled. RESULTS: the mean standard deviation age of the patients was 58.5 +/- 13.1 years, 49.1% were male, and 48.2% had coronary artery disease. Most were receiving statin (similar to 99%). of these, 57.6% were on high-intensity statin therapy, 49.1% on the highest dose available, and 13.0% used a statin together with a cholesterol absorption inhibitor (CAI). Mean +/- standard deviation LDL-C level was 5.6 +/- 3.0 mmol/L before LMT and 3.3 +/- 2.0 mmol/L at enrollment. Overall, 32.0% of patients achieved their LDL-C target. Target achievement rates were 36.6% for patients with coronary artery disease, and 27.5% for those without, and 27.9%, 28.0%, and 37.5% for patients treated with a statin plus CAI, highest-dose statin (no CAI), and lower-dose statin (no CAI), respectively. CONCLUSIONS: LDL-C target achievement rates were low in patients with FH, even in those receiving intensive LMT. Factors that are likely to have contributed to the low LDL-C target achievement rates include high baseline LDL-C, inadequate statin dosages, and low use of CAI. Many patients would have been eligible for proprotein convertase subtilisin/kexin type 9 inhibitor therapy. (C) 2019 National Lipid Association. Published by Elsevier Inc.
Sanofi, FranceSanofi-Aventis
This work was supported by Sanofi, France.