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Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography
Background: Familial hypercholesterolemia (FH) has been associated with early coronary artery disease (CAD) and increased risk of atherosclerotic cardiovascular disease. However, the prevalence of FH and its long-term outcomes in a CAD-high-risk cohort, defined as patients with hypercholesteremia wh...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467756/ https://www.ncbi.nlm.nih.gov/pubmed/34573395 http://dx.doi.org/10.3390/genes12091413 |
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author | Lee, Wen-Jane Chuang, Han-Ni Chen, Yi-Ming Liang, Kae-Woei Tung, Hsin Chen, Jun-Peng Lee, I-Te Wang, Jun-Sing Lin, Ching-Heng Lin, Hsueh-Ju Sheu, Wayne Huey-Herng Lee, Wen-Lieng Hsiao, Tzu-Hung |
author_facet | Lee, Wen-Jane Chuang, Han-Ni Chen, Yi-Ming Liang, Kae-Woei Tung, Hsin Chen, Jun-Peng Lee, I-Te Wang, Jun-Sing Lin, Ching-Heng Lin, Hsueh-Ju Sheu, Wayne Huey-Herng Lee, Wen-Lieng Hsiao, Tzu-Hung |
author_sort | Lee, Wen-Jane |
collection | PubMed |
description | Background: Familial hypercholesterolemia (FH) has been associated with early coronary artery disease (CAD) and increased risk of atherosclerotic cardiovascular disease. However, the prevalence of FH and its long-term outcomes in a CAD-high-risk cohort, defined as patients with hypercholesteremia who underwent coronary angiography, remains unknown. Besides, studies regarding the impact of genetic variations in FH on long-term cardiovascular (CV) outcomes are scarce. Methods and Results: In total, 285 patients hospitalized for coronary angiography with blood low-density lipoprotein cholesterol (LDL-C) levels ≥ 160 mg/dL were sequenced to detect FH genetic variations in LDL receptors apolipoprotein B and proprotein convertase subtilisin/kexin type 9. Risk factors associated with long-term CV outcomes were evaluated. The prevalence of FH was high (14.4%). CAD and early CAD were significantly more prevalent among FH variation carriers than non-carriers, despite comparable blood LDL-C levels. Moreover, the FH variation carriers also underwent more revascularization after a mean follow-up of 6.1 years. Multivariate logistic regression demonstrated that FH genetic variation was associated with increased incidence of cardiovascular disease and mortality (odds ratio = 3.17, p = 0.047). Two common FH variants, LDLR c.986G>A and LDLR c.268G>A, showed the most significant impacts on high blood LDL-C levels and early-onset CAD. Conclusions: Our results indicate that FH genetic variants may exhibit differential effects on early-onset CAD and revascularization risks in patients undergoing coronary angiography. FH genetic information might help identify high-risk patients with typical CAD symptoms for appropriate intervention. |
format | Online Article Text |
id | pubmed-8467756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-84677562021-09-27 Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography Lee, Wen-Jane Chuang, Han-Ni Chen, Yi-Ming Liang, Kae-Woei Tung, Hsin Chen, Jun-Peng Lee, I-Te Wang, Jun-Sing Lin, Ching-Heng Lin, Hsueh-Ju Sheu, Wayne Huey-Herng Lee, Wen-Lieng Hsiao, Tzu-Hung Genes (Basel) Article Background: Familial hypercholesterolemia (FH) has been associated with early coronary artery disease (CAD) and increased risk of atherosclerotic cardiovascular disease. However, the prevalence of FH and its long-term outcomes in a CAD-high-risk cohort, defined as patients with hypercholesteremia who underwent coronary angiography, remains unknown. Besides, studies regarding the impact of genetic variations in FH on long-term cardiovascular (CV) outcomes are scarce. Methods and Results: In total, 285 patients hospitalized for coronary angiography with blood low-density lipoprotein cholesterol (LDL-C) levels ≥ 160 mg/dL were sequenced to detect FH genetic variations in LDL receptors apolipoprotein B and proprotein convertase subtilisin/kexin type 9. Risk factors associated with long-term CV outcomes were evaluated. The prevalence of FH was high (14.4%). CAD and early CAD were significantly more prevalent among FH variation carriers than non-carriers, despite comparable blood LDL-C levels. Moreover, the FH variation carriers also underwent more revascularization after a mean follow-up of 6.1 years. Multivariate logistic regression demonstrated that FH genetic variation was associated with increased incidence of cardiovascular disease and mortality (odds ratio = 3.17, p = 0.047). Two common FH variants, LDLR c.986G>A and LDLR c.268G>A, showed the most significant impacts on high blood LDL-C levels and early-onset CAD. Conclusions: Our results indicate that FH genetic variants may exhibit differential effects on early-onset CAD and revascularization risks in patients undergoing coronary angiography. FH genetic information might help identify high-risk patients with typical CAD symptoms for appropriate intervention. MDPI 2021-09-14 /pmc/articles/PMC8467756/ /pubmed/34573395 http://dx.doi.org/10.3390/genes12091413 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lee, Wen-Jane Chuang, Han-Ni Chen, Yi-Ming Liang, Kae-Woei Tung, Hsin Chen, Jun-Peng Lee, I-Te Wang, Jun-Sing Lin, Ching-Heng Lin, Hsueh-Ju Sheu, Wayne Huey-Herng Lee, Wen-Lieng Hsiao, Tzu-Hung Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography |
title | Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography |
title_full | Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography |
title_fullStr | Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography |
title_full_unstemmed | Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography |
title_short | Familial Hypercholesterolemia Genetic Variations and Long-Term Cardiovascular Outcomes in Patients with Hypercholesterolemia Who Underwent Coronary Angiography |
title_sort | familial hypercholesterolemia genetic variations and long-term cardiovascular outcomes in patients with hypercholesterolemia who underwent coronary angiography |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467756/ https://www.ncbi.nlm.nih.gov/pubmed/34573395 http://dx.doi.org/10.3390/genes12091413 |
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