所属 医学部 医学科（東京女子医科大学病院） 職種 准教授
|発表タイトル||Underdiagnosis and Under Treatment of Heterozygous Familial Hypercholesterelemia in Cardiovascular Diseases|
|発表者・共同発表者||◎関口治樹, 佐藤加代子, 神林敬悟, 飯田達郎, 高野真弓, 坂井晶子, 萩原誠久|
|学会抄録||第81回日本循環器学会学術集会 プログラム集 461|
|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.
AIMS: 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±15.4years) according to FH guidelines. We compared lipids profiles between hFH and the patients with hypercholesterolemia (DL,68.3±15.0years). 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.
CONCLUSION: 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.