[Prevalence and clinical features of familial hypercholesterolemia in Chinese patients with myocardial infarction]

Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Feb 24;46(2):109-113. doi: 10.3760/cma.j.issn.0253-3758.2018.02.008.
[Article in Chinese]

Abstract

Objective: To analyze the prevalence and clinical features of familial hypercholesterolemia (FH) in Chinese patients with myocardial infarction (MI). Method: This retrospective study recruited a total of 2 119 consecutive patients (age (56.7±10.9) years old) undergoing coronary angiography with first MI from April 2011 to December 2016. Patients were divided into 2 groups: premature MI (male<55 years old, female<60 years old) and non-premature MI. The diagnosis of FH was established according to Dutch Lipid Clinic Network (DLCN) diagnostic criteria and referred as definite/probable FH in our study. The prevalence and clinical features of FH, including lipid level, MI characteristics and stain therapy, were explored. Multivariable logistic regression analysis was used to assess the predictive value of FH for the presence of premature MI. Results: The prevalence of definite/probable FH was 3.68% (78/2 119) in MI patients and 7.28% (68/934) in premature MI patients. Onset of MI occurred 10 years earlier in patients with definite/probable FH than those without FH ((47.9±9.4) years vs. (58.8±10.7) years, P<0.01). Additionally, we found that the risk of premature MI was significantly and independently increased in definite/probable FH patients (OR=5.32, 95%CI 2.77-10.22, P<0.01). None of FH patients reached the target of LDL-C<1.8 mmol/L under statin therapy. Conclusions: The prevalence of FH in Chinese patients with MI is not rare. Clinically, FH is linked with the early onset of MI.

目的: 分析心肌梗死(心梗)患者中家族性高胆固醇血症(FH)的检出率及其临床特点。 方法: 本研究为回顾性研究,连续入选2011年4月至2016年12月于阜外医院血脂中心就诊的初发心梗患者2 119例,年龄(56.7±10.9)岁,分为早发心梗组(男性<55岁,女性<60岁;934例)与非早发心梗组(1 134例)。收集临床资料,根据荷兰临床脂质网络标准进行评分,将确诊/很可能FH诊断为FH。分析FH的检出率、血脂水平、心梗特点及他汀治疗情况,并采用多因素logistic回归分析FH对早发心梗的预测作用。 结果: 初发心梗患者中FH的检出率为3.68%(78/2 119),早发心梗患者中为7.28%(68/934),两组性别差异无统计学意义(P>0.05)。FH患者心梗发病年龄明显低于非FH患者[(47.9±9.4)岁比(58.8±10.7)岁, P<0.01]。多因素logistic回归分析提示FH患者早发心梗风险为非FH患者的5.32倍(OR=5.32, 95%CI 2.77~10.22, P<0.01)。本研究检出的FH患者中无患者经调脂治疗达到LDL-C<1.8 mmol/L。 结论: FH在中国心梗患者中并非少见,是早发心梗的重要原因。.

Keywords: Familial hypercholesterolemia; Myocardial infarction; Prevalence; Risk factors.

MeSH terms

  • Adult
  • Asian People
  • China / epidemiology
  • Cholesterol, LDL
  • Coronary Angiography
  • Female
  • Humans
  • Hyperlipoproteinemia Type II / epidemiology
  • Hyperlipoproteinemia Type II / pathology*
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / pathology
  • Prevalence
  • Retrospective Studies
  • Risk Factors

Substances

  • Cholesterol, LDL