Familial hypercholesterolemia and atherosclerotic cardiovascular mortality among Korean adults with low levels of serum cholesterol.

Abstract:

BACKGROUND AND AIMS:A few studies examined association between familial hypercholesterolemia (FH) and atherosclerotic cardiovascular disease (ASCVD) in Asians with low levels of serum cholesterol. The objectives of this study were to estimate the prevalence of familial hypercholesterolemia phenotype (FH-P) and examined their associations with cardiovascular mortality among Korean population. METHODS:The Korea National Health and Nutrition Examination Survey (KNHANES) data and data from a cohort study were used to obtain the prevalence estimate of FH-P and the association of FH-P with mortality, respectively. A cohort study included 502,966 individuals who visited health promotion centers and were given a medical examination from 1994 to 2004. FH-P was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria and the modified MEDPED which substracted 20 mg/dL from original MEDPED. RESULTS:FH-P prevalences defined by MEDPED and modified MEDPED among KNHANES were 0.11% and 0.25%. After 14.6-year follow-up, 23,413 deaths (3888 ASCVD) were observed. Overall, FH-P defined by MEDPED showed weaker associations with mortality compared with modified MEDPED. The hazard ratios (95% confidence intervals) of FH-P defined by modified MEDPED were 1.74 (1.46-2.07) for all-cause death, 2.18 (1.51-3.14) for ASCVD, and 2.06 (1.66-2.56) for non-cancer. Of note, the hazard ratios for all-cause death was 5.27 (2.62-10.57) among women aged less than 50 years. CONCLUSIONS:FH-P increased all-cause and ASCVD mortality. Long-term follow-up studies with detailed information on cause of mortality are necessary to confirm these findings. Subjects with FH are at high risk for death and need appropriate treatment and management.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Jung KJ,Koh H,Choi Y,Lee SJ,Ji E,Jee SH

doi

10.1016/j.atherosclerosis.2018.09.012

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

103-109

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(18)31374-1

journal_volume

278

pub_type

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