カンバヤシ ケイゴ   Kanbayashi Keigo
  神林 敬悟
   所属   医学部 医学科(東京女子医科大学病院)
   職種   助手
言語種別 英語
発表タイトル Under-diagnosis and Under-treatment of Heterozygous Familial Hypercholesterelaemia in Patients with Cardiovascular Diseases
会議名 ESC CONGRESS 2017
主催者 European Society of Cardiology
学会区分 国際学会及び海外の学会
発表形式 ポスター掲示
講演区分 一般
発表者・共同発表者SEKIGUCHI Haruki, IIDA Tatsuro, KANBAYASHI Keigo, TAKANO Mayu, ◎SAKAI Akiko, SATO Kayoko, HAGIWARA Nobuhisa
発表年月日 2017/08/29
開催地
(都市, 国名)
Barcelona, SPAIN
学会抄録 European Heart Journal 38(suppl_1),6498 2017
概要 Background: Heterozygous familial hypercholesterolaemia (hFH) is most common genetic disease and cause of premature cardiovascular disease (CVD). However, the diagnosis rate is less than 0.1% in Japan.

Purpose: We examined the patients hospitalized for CVD and evaluate the extent to which hFH is underdiagnosed and undertreated.

Methods: We analyzed the consecutive 553 patients hospitalized for CVD from 2013 to 2015. To investigate the prevalence of hFH, we focused on the patients with high LDL-C levels more than 140mg/dL in these CVD patients.

Results: Sixty-four patients had high LDL-C levels. In those, 37 (6.7% of all CVD) patients were diagnosed as hFH (62.9±15.4 years) according to FH guidelines. We compared lipids profiles between hFH and the patients with hypercholesterolemia (DL, 68.3±15.0 years). The hFH patients had significantly higher T-cho levels (243.8±32.3mg/dL, 224.1±15.0mg/dL, P<0.01, respectively) and LDL-C levels (172.5±24.2mg/dL, 152.3±8.2mg/dL, P<0.01, respectively) than DL patients. Blood pressure, EF, TG, HDL-C, Cre, BNP, CRP were not significant difference between hFH and DL. Furthermore, 32.4% of hFH had the past history of CVD. However, just 27% of hFH were treated with statins on admission, and also only 0.05% of hFH had a definitive diagnosis at discharge.

Conclusions Owing to severe underdiagnosis and under treatment of hFH, there is an urgent need for diagnostic screening together with early and aggressive treatments of high-risk condition of future cardiovascular events.