Abstract 9313: Progression of Coronary Plaque Burden In Patients With Familial Hypercholesterolaemia: Assessment With Coronary CT
Background: It is well known that patients with familial hypercholesterolemia (FH) exhibit markedly elevated LDL-C levels resulting premature coronary artery disease. Statins have been shown to be effective in delaying the onset of coronary artery disease even in patients with FH. However, the optimal timing for initiation of lipid-lowering therapy for heterozygous FH patients still remains unclear. The aim of our study was to determine the optimal timing for initiation of lipid-lowering therapy for heterozygous FH.
Methods and Results: Genetically determined 42 heterozygous FH patients were included in this study (mean age 54±13, male=23, initial mean LDL-C=250±40mg/dl). All patients underwent contrast-enhanced 64-slice coronary CT using the standard protocol. We evaluated coronary plaque burden assigning score (0 to 5) to each of 15 coronary artery segments according to the Society Cardiovascular Computed Tomography guideline. Almost all FH patients were treated with statins during a period of 8±4 years before coronary CT. From the regression equations between age (X) and stenosis index (Y) (Figure), we can assume that coronary artery stenosis detectable by coronary CT will occur after 17 years of age in male, and 28 years in female heterozygotes FH patients, respectively even under the statin uses .
Conclusions: These data suggest that coronary artery stenosis detectable by coronary CT will occur after 17 and 28 years of age in male and female heterozygous FH, respectively, even in the strong statin era. We suggest that the lipid-lowering therapy for heterozygous FH should start at least by these early ages in terms of prevention from coronary plaque burden.
- © 2013 by American Heart Association, Inc.