坂井 晶子
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Language English
Title Under-diagnosis and Under-treatment of Heterozygous Familial Hypercholesterelaemia in Patients with Cardiovascular Diseases
Conference ESC CONGRESS 2017
Promoters European Society of Cardiology
Conference Type International society and overseas society
Presentation Type Poster notice
Lecture Type General
Publisher and common publisherSEKIGUCHI Haruki, IIDA Tatsuro, KANBAYASHI Keigo, TAKANO Mayu, ◎SAKAI Akiko, SATO Kayoko, HAGIWARA Nobuhisa
Date 2017/08/29
Venue
(city and name of the country)
Barcelona, SPAIN
Society abstract European Heart Journal 38(suppl_1),6498 2017
Summary 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.