Coronary computed tomographic angiography findings and their therapeutic implications in asymptomatic patients with familial hypercholesterolemia. Lessons from the SAFEHEART study

Journal of Clinical Lipidology
Leopoldo Pérez de IslaSAFEHEART Investigators

Abstract

Familial hypercholesterolemia (FH) confers an increased risk of premature atherosclerotic disease. Coronary computed tomographic angiography (CTA) can assess preclinical coronary atherosclerosis. To describe coronary CTA findings in asymptomatic molecularly defined FH individuals, to identify those factors related to its presence and extension, and to assess the impact of these results in patients' care and estimated risk. Four hundred and forty individuals with FH, without clinical cardiovascular disease, were consecutively enrolled and underwent a coronary CTA that was used to analyze coronary atherosclerosis based on coronary calcium score (CCS), sum of stenosis severity, and plaque composition sum (PCS). For FH patients, cardiovascular risk was estimated using the specific SAFEHEART risk equation. Follow-up was performed using a standardized protocol. Mean age was 46.4 years (231 women, 52%). Coronary calcium was present in 55%, mean CCS was 130.9, 46% had a plaque with lumen involvement, and mean PCS was 1.1. During follow-up, there were 17 (4%) nonfatal events and 2 (1%) fatal events. CCS was independently associated to the estimated risk and low-density lipoprotein-cholesterol life-years, sum of stenosis severity to the ...Continue Reading

Associated Clinical Trials

Citations

Nov 2, 2018·Current Opinion in Lipidology·Pedro MataLeopoldo Pérez de Isla
Dec 11, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Elfriede RuttmannHanno Ulmer
Aug 11, 2020·Current Atherosclerosis Reports·Kuang-Yuh ChyuPrediman K Shah
Jan 25, 2020·Nature Reviews. Cardiology·Gerald F WattsKausik K Ray
Dec 15, 2020·Heart, Lung & Circulation·Gerald F WattsUNKNOWN FH Australasia Network Consensus Working Group
Mar 25, 2020·Trends in Cardiovascular Medicine·Vanessa BianconiUNKNOWN International Lipid Expert Panel (ILEP)
Jul 21, 2020·Atherosclerosis·Antonio GalloUNKNOWN French REgistry of Familial hypERCHOLesterolemia (REFERCHOL) investigators
May 1, 2021·Journal of the Endocrine Society·David T W LuiKathryn C B Tan
May 8, 2021·Journal of the American College of Radiology : JACR·UNKNOWN Expert Panel on Cardiac ImagingSuhny Abbara
May 11, 2021·Clínica e investigación en arteriosclerosis : publicación oficial de la Sociedad Española de Arteriosclerosis·Carlos Escobar Cervantes, Leopoldo Pérez de Isla
Jul 31, 2021·American Journal of Preventive Cardiology·Gerald F WattsUNKNOWN FH Australasia Network Consensus Working Group
Jul 19, 2021·JACC. Cardiovascular Imaging·Antonio GalloUNKNOWN REFERCHOL and SAFEHEART Investigators
Aug 20, 2021·Arteriosclerosis, Thrombosis, and Vascular Biology·Eythór BjörnssonKári Stefánsson
Nov 2, 2019·Progress in Cardiovascular Diseases·Marcio H Miname, Raul D Santos

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