Coronary artery disease in heterozygous familial hypercholesterolemia patients with the same LDL receptor gene mutation.

Abstract:

BACKGROUND:Familial hypercholesterolemia (FH), an autosomal codominant disease, is characterized by high levels of LDL cholesterol and a high incidence of coronary artery disease (CAD). To date, genetic heterogeneity has hindered the proper assessment of the relation between risk factors and CAD in FH patients. METHODS AND RESULTS:We studied the association between CAD and common risk factors in a sample of 263 French Canadian FH patients (147 women, 116 men) carrying the same > 10-kb deletion of the LDL receptor gene. Thirty-five women and 54 men had CAD. The mean age of onset of CAD was 45.6 +/- 12.7 years in women and 38.8 +/- 9.4 years in men. Multiple logistic regression analyses were performed to test the association between CAD and age, tendon xanthomas, cigarette smoking, hypertension, diabetes mellitus, apolipoprotein E polymorphism, total plasma cholesterol, triglycerides, VLDL cholesterol, LDL cholesterol, HDL cholesterol, and lipoprotein(a) [Lp(a)]. In FH women, significant multivariate predictors were age (odds ratio, 1.10 for 1 year; P < .0001), VLDL cholesterol (odds ratio, 3.85 for 1 natural log unit; P < .002), and LDL cholesterol (odds ratio, 1.42 for 1 mmol/L; P < .02). In FH men, age (odds ratio, 1.08 for 1 year; P < .0001) and HDL cholesterol (odds ratio, 0.14 for 1 mmol/L; P = .05) were significant predictors of disease. Lp(a) was not a significant predictor in univariate or multivariate analyses. CONCLUSIONS:This study suggests that increased risk of CAD in FH is not solely due to elevated LDL cholesterol levels and demonstrates a sex-specific lipoprotein influence on CAD in a large sample of FH patients carrying the same LDL receptor gene defect.

journal_name

Circulation

journal_title

Circulation

authors

Ferrières J,Lambert J,Lussier-Cacan S,Davignon J

doi

10.1161/01.cir.92.3.290

subject

Has Abstract

pub_date

1995-08-01 00:00:00

pages

290-5

issue

3

eissn

0009-7322

issn

1524-4539

journal_volume

92

pub_type

临床试验,杂志文章
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    pub_type: 杂志文章,评审

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    更新日期:2007-05-15 00:00:00

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 临床试验,杂志文章,随机对照试验

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