The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia

In patients with familial hypercholesterolemia (FH) the exposure of very high LDL-C concentration and cumulative LDL-C level (cum LDL-C) can play a significant role in the prognosis. Objective: to analyze the contribution of “cum LDL-C for all life” and the index “cum LDL-C/age” to the development o...

Descripción completa

Detalles Bibliográficos
Autores principales: Korneva, Victoria, Kuznetsova, Tatyana, Julius, Ulrich
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778155/
https://www.ncbi.nlm.nih.gov/pubmed/35055385
http://dx.doi.org/10.3390/jpm12010071
_version_ 1784637250208792576
author Korneva, Victoria
Kuznetsova, Tatyana
Julius, Ulrich
author_facet Korneva, Victoria
Kuznetsova, Tatyana
Julius, Ulrich
author_sort Korneva, Victoria
collection PubMed
description In patients with familial hypercholesterolemia (FH) the exposure of very high LDL-C concentration and cumulative LDL-C level (cum LDL-C) can play a significant role in the prognosis. Objective: to analyze the contribution of “cum LDL-C for all life” and the index “cum LDL-C/age” to the development of coronary heart disease (CHD), myocardial infarction (MI), and a combined end point: MI, stroke, unstable angina in FH patients. Methods: 188 patients (mean age 49.2 years, males 45.7%) with FH were examined (Dutch Lipid Clinic Criteria). We had evaluated cumulative LDL-C and index “cum DL-C/age” along with other classical risk factors. Cum LDL-C was calculated as LDL-Cmax × (age at initiating of hypolipidemic therapy) + LDL-C at inclusion age at initiation/correction therapy). Cumulative LDL-C and “cum LDL-C/age” were calculated as the ratio cum LDL-C to age. The follow-up period was 5.4 (from 3 to 10) years. Results: The index “cum LDL-C/age” was higher in patients with CHD 58.7 ± 10.4 mmol/L/years vs. 40.1 ± 11.7 mmol/L/years in patients without CHD (p < 0.001). According to our data based on the results of the logistic regression analysis in patients with FH, cumulative LDL-C and the cumulative index “cum LDL–C/age” played a strong predictive role in the development of CHD in FH patients; it was greater than the role of TC and LDL-C concentrations. We present ROC curves for CHD, MI and combined end point in FH patients, and a prognostic scale for CHD development, which is based on classical cardiovascular risk factors. Conclusion: cumulative LDL-C level plays an important role in the development of CHD in FH patients.
format Online
Article
Text
id pubmed-8778155
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87781552022-01-22 The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia Korneva, Victoria Kuznetsova, Tatyana Julius, Ulrich J Pers Med Article In patients with familial hypercholesterolemia (FH) the exposure of very high LDL-C concentration and cumulative LDL-C level (cum LDL-C) can play a significant role in the prognosis. Objective: to analyze the contribution of “cum LDL-C for all life” and the index “cum LDL-C/age” to the development of coronary heart disease (CHD), myocardial infarction (MI), and a combined end point: MI, stroke, unstable angina in FH patients. Methods: 188 patients (mean age 49.2 years, males 45.7%) with FH were examined (Dutch Lipid Clinic Criteria). We had evaluated cumulative LDL-C and index “cum DL-C/age” along with other classical risk factors. Cum LDL-C was calculated as LDL-Cmax × (age at initiating of hypolipidemic therapy) + LDL-C at inclusion age at initiation/correction therapy). Cumulative LDL-C and “cum LDL-C/age” were calculated as the ratio cum LDL-C to age. The follow-up period was 5.4 (from 3 to 10) years. Results: The index “cum LDL-C/age” was higher in patients with CHD 58.7 ± 10.4 mmol/L/years vs. 40.1 ± 11.7 mmol/L/years in patients without CHD (p < 0.001). According to our data based on the results of the logistic regression analysis in patients with FH, cumulative LDL-C and the cumulative index “cum LDL–C/age” played a strong predictive role in the development of CHD in FH patients; it was greater than the role of TC and LDL-C concentrations. We present ROC curves for CHD, MI and combined end point in FH patients, and a prognostic scale for CHD development, which is based on classical cardiovascular risk factors. Conclusion: cumulative LDL-C level plays an important role in the development of CHD in FH patients. MDPI 2022-01-07 /pmc/articles/PMC8778155/ /pubmed/35055385 http://dx.doi.org/10.3390/jpm12010071 Text en © 2022 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
Korneva, Victoria
Kuznetsova, Tatyana
Julius, Ulrich
The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia
title The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia
title_full The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia
title_fullStr The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia
title_full_unstemmed The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia
title_short The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia
title_sort role of cumulative ldl cholesterol in cardiovascular disease development in patients with familial hypercholesterolemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778155/
https://www.ncbi.nlm.nih.gov/pubmed/35055385
http://dx.doi.org/10.3390/jpm12010071
work_keys_str_mv AT kornevavictoria theroleofcumulativeldlcholesterolincardiovasculardiseasedevelopmentinpatientswithfamilialhypercholesterolemia
AT kuznetsovatatyana theroleofcumulativeldlcholesterolincardiovasculardiseasedevelopmentinpatientswithfamilialhypercholesterolemia
AT juliusulrich theroleofcumulativeldlcholesterolincardiovasculardiseasedevelopmentinpatientswithfamilialhypercholesterolemia
AT kornevavictoria roleofcumulativeldlcholesterolincardiovasculardiseasedevelopmentinpatientswithfamilialhypercholesterolemia
AT kuznetsovatatyana roleofcumulativeldlcholesterolincardiovasculardiseasedevelopmentinpatientswithfamilialhypercholesterolemia
AT juliusulrich roleofcumulativeldlcholesterolincardiovasculardiseasedevelopmentinpatientswithfamilialhypercholesterolemia