Atherosclerosis. Supplements最新文献

{"title":"Efficiency and problems of statin therapy in patients with heterozygous familial hypercholesterolemia","authors":"Viktoria Korneva ,&nbsp;Tatiana Kuznetsova ,&nbsp;Ulrich Julius","doi":"10.1016/j.atherosclerosissup.2019.08.029","DOIUrl":"10.1016/j.atherosclerosissup.2019.08.029","url":null,"abstract":"<div><p>Familial hypercholesterolemia (FH) is associated with a very high risk of cardiovascular complications and the need for an early aggressive lipid-lowering therapy. The achievement of lipid target levels is often an extremely difficult task in these patients.</p></div><div><h3>Aims</h3><p><span>to analyze sex and age structure of ischemic heart disease (IHD) </span>in patients<span> with a definite, possible and probable FH. to assess the degree of achievement of low density lipoprotein cholesterol (LDL-C) target levels in FH patients on statin therapy and complications that occur during therapy; to analyze the adherence of FH patients to statin therapy and reveal the factors which have an influence on it.</span></p></div><div><h3>Materials and methods</h3><p>The analysis of IHD clinical characteristics was performed in 253 FH patients from Karelian register, mean age 52.5 years (confidence interval, CI 22.0; 78.0). Using Dutch Lipid Clinic Network Criteria (DLCN), we established the diagnosis of FH as “definite” if the total number of points was more than eight, “probable” – if the number of points was 6–8, “possible” if the number of points was 3–5. The diagnosis was considered to be excluded if the score was less than three. A definite FH was diagnosed in 96 patients.</p><p>For the evaluation of target LDL-C levels achievement on statin therapy we analyzed data from 191 FH patients (75 males). For the evaluation of adherence to statin therapy Morisky-Green questionnaire was used in 93 definite FH patients.</p></div><div><h3>Results</h3><p>In the group with a definite FH the incidence of IHD in the age range from 39 to 60 years was higher in women than in men (50% and 39.4%, p &gt; 0.05), in patients older than 60 years IHD was observed in 66.7% of women and 50% of men (p &gt; 0.05). In general, in the group with a definite FH, the frequency of IHD was more than three times higher in the age group over 40 years compared with patients under 40 years.</p><p>57% of patients with a definite FH were adherent to lipid-lowering therapy, 16% had partial adherence and no adherence to therapy was documented in 27% of patients. The achievement of LDL-C target levels was 19.2%: 22.6% in definite FH group and 12.5% in possible FH.</p><p>Smoking and gender were not associated with adherence to statin therapy. Associated factors with increased adherence to statin therapy were age (p = 0.000003), arterial hypertension (OR = 1.90 (1.02; to 3.55), p = 0.044), the history of IHD (OR = 2.99 (1.50; of 5.97) p = 0.002), myocardial infarction (OR = 5.26 (2.03; 13.60), p = 0.0006), myocardial revascularization (OR = 20.3 (2.64; 156.11), p = 0.004) and the fact of target LDL-cholesterol levels achievement (OR = 19.93 (7.03; 56.50), p &lt; 0.0001).</p><p><span>The main reason for the non-acceptance of statin therapy for FH patients was the fear of side effects in 87%. The main reasons for stopping current statin intake were myalgia in 12%, an increase in </span>t","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"40 ","pages":"Pages 79-87"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.atherosclerosissup.2019.08.029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73494010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}