Elevated lipoprotein(a), hypertension and renal insufficiency found to be independent risk factors for CAD in patients with familial hypercholesterolemia

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Takeaway

  • Elevated lipoprotein(a) [Lp(a)], hypertension and renal insufficiency are independent risk factors that predict CAD in patients with familial hypercholesterolemia (FH) beyond elevated pretreatment LDL-cholesterol; despite the cross-sectional design, this study proposes a need for identifying and managing these factors to reduce excess CAD risk in FH patients.

Study design

  • This cross-sectional study compared clinical and biochemical parameters in 390 patients with genetically confirmed FH with and without CAD.

Key results

  • Compared to FH patients without CAD, those with CAD were older and more often male, and had a higher prevalence of hypertension, smoking, diabetes, obesity, reduced eGFR, and elevated plasma Lp(a) and pre-treatment LDL-cholesterol and triglyceride (or low HDL-cholesterol) levels (P<.05 for all).
  • Univariate analyses found that age, male gender, smoking, hypertension, reduced eGFR, diabetes, obesity, plasma creatinine, Lp(a) and pretreatment LDL-cholesterol, triglyceride and HDL-cholesterol levels were significant predictors of CAD in FH patients (P<.05 for all).
  • Increased LDL-cholesterol, elevated Lp(a), hypertension and reduced eGFR were significant independent predictors of CAD (P<.05 for all) after adjusting for other modifiable risk factors.