Improvement in LDL-cholesterol levels of patients with familial hypercholesterolemia: can we do better? Analysis of results obtained during the past two decades in 1669 French subjects - Archive ouverte HAL Access content directly
Journal Articles Atherosclerosis Year : 2014

Improvement in LDL-cholesterol levels of patients with familial hypercholesterolemia: can we do better? Analysis of results obtained during the past two decades in 1669 French subjects

S. Beliard
  • Function : Author
V. Carreau
  • Function : Author
A. Carrie
  • Function : Author
P. Giral
  • Function : Author
E. Duchene
  • Function : Author
M. Farnier
  • Function : Author
J. Ferrieres
  • Function : Author
A. Fredenrich
  • Function : Author
M. Krempf
  • Function : Author
G. Luc
  • Function : Author
E. Bruckert
  • Function : Author

Abstract

BACKGROUND: Heterozygous Familial Hypercholesterolemia (heFH) is an autosomal disease that affects about 1/500 people. It is characterized by markedly elevated plasma LDL-cholesterol (C) levels and an increased risk of cardiovascular disease (CVD). The aim of this study was to measure changes in LDL-C levels in heFH patients over two decades, and to evaluate if patients achieved LDL-C targets. METHODS: Data from 1669 heFH patients in five academic French centers were recorded between 1988 and 2011. RESULTS: The mean LDL-C concentrations under medical care improved between 1988 and 2011 (245 mg/dL before 1995, 164 mg/dL after 2009; p \textless 0.0001). However, mean LDL-C level and the number of patients treated with statins (79.3%) have not improved since 2005. In patients registered and treated after 2005 (n = 616), only 10.4% reached target LDL-C levels of \textless100 mg/dL. Indeed, 29.4% (n = 181) were treated with a maximal therapy (statins with a potency of \textgreater45% LDL-C reduction plus at least another lipid-lowering agent). Despite maximal treatment, only 18.8% of these heFH patients (n = 34/181) reached target LDL-C levels of \textless100 mg/dL. In addition, 75.3% of patients with CVD did not reach the LDL-C of \textless100 mg/dL. CONCLUSION: This study demonstrates that after significant improvement over the past two decades, the mean LDL-C levels in heFH French patients has remained stable since 2005. We also show that most heFH patients are not achieving their recommended LDL-C goals: this highlights the need for improved treatment and for new therapeutics in this population.
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hal-01859380 , version 1 (22-08-2018)

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S. Beliard, V. Carreau, A. Carrie, P. Giral, E. Duchene, et al.. Improvement in LDL-cholesterol levels of patients with familial hypercholesterolemia: can we do better? Analysis of results obtained during the past two decades in 1669 French subjects. Atherosclerosis, 2014, 234 (1), pp.136-41. ⟨10.1016/j.atherosclerosis.2014.02.021⟩. ⟨hal-01859380⟩
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