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Age- and sex-based heterogeneity in coronary artery plaque presence and burden in familial hypercholesterolemia: A multi-national study

التفاصيل البيبلوغرافية
العنوان: Age- and sex-based heterogeneity in coronary artery plaque presence and burden in familial hypercholesterolemia: A multi-national study
المؤلفون: Khurram Nasir, Reed Mszar, Miguel Cainzos-Achirica, Gowtham R. Grandhi, Tycho R. Tromp, Rodrigo Alonso, Márcio S. Bittencourt, Eric Bruckert, José Luis Díaz-Díaz, Antonio Gallo, G. Kees Hovingh, Marcio H. Miname, Ovidio Muñiz-Grijalvo, Jing Pang, Leopoldo Perez de Isla, Eric J.G. Sijbrands, Gerald F. Watts, Pedro Mata, Raul D. Santos
المصدر: American Journal of Preventive Cardiology, Vol 17, Iss , Pp 100611- (2024)
بيانات النشر: Elsevier, 2024.
سنة النشر: 2024
المجموعة: LCC:Diseases of the circulatory (Cardiovascular) system
LCC:Public aspects of medicine
مصطلحات موضوعية: Atherosclerotic cardiovascular disease, Coronary artery calcium, Familial hypercholesterolemia, Low-density lipoprotein cholesterol, Plaque burden, Diseases of the circulatory (Cardiovascular) system, RC666-701, Public aspects of medicine, RA1-1270
الوصف: Objectives: Individuals with familial hypercholesterolemia (FH) are at an increased risk for coronary artery disease (CAD). While prior research has shown variability in coronary artery calcification (CAC) among those with FH, studies with small sample sizes and single-center recruitment have been limited in their ability to characterize CAC and plaque burden in subgroups based on age and sex. Understanding the spectrum of atherosclerosis may result in personalized risk assessment and tailored allocation of costly add-on, non-statin lipid-lowering therapies. We aimed to characterize the presence and burden of CAC and coronary plaque on computed tomography angiography (CTA) across age- and sex-stratified subgroups of individuals with FH who were without CAD at baseline. Methods: We pooled 1,011 patients from six cohorts across Brazil, France, the Netherlands, Spain, and Australia. Our main measures of subclinical atherosclerosis included CAC ranges (i.e., 0, 1–100, 101–400, >400) and CTA-derived plaque burden (i.e., no plaque, non-obstructive CAD, obstructive CAD). Results: Ninety-five percent of individuals with FH (mean age: 48 years; 54% female; treated LDL-C: 154 mg/dL) had a molecular diagnosis and 899 (89%) were on statin therapy. Overall, 423 (42%) had CAC=0, 329 (33%) had CAC 1–100, 160 (16%) had CAC 101–400, and 99 (10%) had CAC >400. Compared to males, female patients were more likely to have CAC=0 (48% [n = 262] vs 35% [n = 161]) and no plaque on CTA (39% [n = 215] vs 26% [n = 120]). Among patients with CAC=0, 85 (20%) had non-obstructive CAD. Females also had a lower prevalence of obstructive CAD in CAC 1–100 (8% [n = 15] vs 18% [n = 26]), CAC 101–400 (32% [n = 22] vs 40% [n = 36]), and CAC >400 (52% [n = 16] vs 65% [n = 44]). Female patients aged 50–59 years were less likely to have obstructive CAD in CAC >400 (55% [n = 6] vs 70% [n = 19]). Conclusion: In this large, multi-national study, we found substantial age- and sex-based heterogeneity in CAC and plaque burden in a cohort of predominantly statin-treated individuals with FH, with evidence for a less pronounced increase in atherosclerosis among female patients. Future studies should examine the predictors of resilience to and long-term implications of the differential burden of subclinical coronary atherosclerosis in this higher risk population.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2666-6677
Relation: http://www.sciencedirect.com/science/article/pii/S2666667723001526; https://doaj.org/toc/2666-6677
DOI: 10.1016/j.ajpc.2023.100611
URL الوصول: https://doaj.org/article/02c543cadbc747008f4f6ac5cb02c969
رقم الأكسشن: edsdoj.02c543cadbc747008f4f6ac5cb02c969
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:26666677
DOI:10.1016/j.ajpc.2023.100611