21. Bệnh tim mạch do xơ vữa và yếu tố nguy cơ ở người tăng cholesterol máu gia đình
Nội dung chính của bài viết
Tóm tắt
Nghiên cứu cắt ngang khảo sát đặc điểm yếu tố nguy cơ tim mạch và ảnh hưởng của các yếu tố này đến bệnh tim mạch (BTM) do xơ vữa với bệnh nhân tăng cholesterol máu gia đình (Familial hypercholesterolemia, FH), dựa trên phân tích dữ liệu 110 bệnh nhân FH tại Việt Nam. Kết quả nghiên cứu ghi nhận bệnh nhân được chẩn đoán FH ở độ tuổi trung bình 51,8 tuổi, với tỉ lệ mắc bệnh mạch vành (BMV) sớm là 35,5%. Tỉ lệ bệnh nhân có hút thuốc lá, thừa cân/béo phì, tăng huyết áp và đái tháo đường tương ứng là 43,6%, 43,6%, 37,3% và 5,5%. Trong đó, hút thuốc lá là yếu tố liên quan đến BMV và BMV sớm, với Odd Ratio tương ứng là 4,1 và 5,4. Tóm lại, nghiên cứu này ghi nhận bệnh nhân FH tại Việt Nam còn được chẩn đoán muộn, nhiều bệnh nhân đã có BTM do xơ vữa và có yếu tố nguy cơ tim mạch làm gia tăng gánh nặng xơ vữa. Điều này gợi ý cần thiết lập chương trình sàng lọc, chẩn đoán và can thiệp sớm FH tại Việt Nam.
Chi tiết bài viết
Từ khóa
Tăng cholesterol máu gia đình, yếu tố nguy cơ, bệnh tim mạch do xơ vữa
Tài liệu tham khảo
1. Hu P, Dharmayat KI, Stevens CAT, et al. Prevalence of Familial Hypercholesterolemia Among the General Population and Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis. Circulation. Jun 2 2020; 141(22): 1742-1759. doi:10.1161/circulationaha.119.044795.
2. Nordestgaard BG, Chapman MJ, Humphries SE, et al. Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. European heart journal. Dec 2013; 34(45): 3478-90a. doi:10.1093/eurheartj/eht273.
3. Risk of fatal coronary heart disease in familial hypercholesterolaemia. Scientific Steering Committee on behalf of the Simon Broome Register Group. BMJ (Clinical research ed). Oct 12 1991; 303(6807): 893-6. doi:10.1136/bmj.303.6807.893.
4. Sijbrands EJ, Westendorp RG, Defesche JC, de Meier PH, Smelt AH, Kastelein JJ. Mortality over two centuries in large pedigree with familial hypercholesterolaemia: family tree mortality study. BMJ (Clinical research ed). Apr 28 2001; 322(7293): 1019-23. doi:10.1136/bmj.322.7293.1019.
5. Vaduganathan M, Mensah GA, Turco JV, Fuster V, Roth GA. The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health. Journal of the American College of Cardiology. Dec 20 2022; 80(25): 2361-2371. doi:10.1016/j.jacc.2022.11.005.
6. Vlad CE, Foia L, Florea L, et al. Evaluation of cardiovascular risk factors in patients with familial hypercholesterolemia from the North-Eastern area of Romania. Lipids in health and disease. Jan 11 2021; 20(1): 4. doi:10.1186/s12944-020-01428-y.
7. Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). Lancet (London, England). Nov 6 2021; 398(10312): 1713-1725. doi:10.1016/s0140-6736(21)01122-3.
8. Wiegman A, Gidding SS, Watts GF, et al. Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment. European heart journal. Sep 21 2015; 36(36):2425-37. doi:10.1093/eurheartj/ehv157
9. Cao YX, Wu NQ, Sun D, et al. Application of expanded genetic analysis in the diagnosis of familial hypercholesterolemia in patients with very early-onset coronary artery disease. Journal of translational medicine. Dec 10 2018; 16(1):345. doi:10.1186/s12967-018-1737-7.
10. Corral P, Geller AS, Polisecki EY, et al. Unusual genetic variants associated with hypercholesterolemia in Argentina. Atherosclerosis. Oct 2018; 277: 256-261. doi:10.1016/j.atherosclerosis.2018.06.009.
11. Durst R, Ibe UK, Shpitzen S, et al. Molecular genetics of familial hypercholesterolemia in Israel-revisited. Atherosclerosis. Feb 2017; 257: 55-63. doi:10.1016/j.atherosclerosis.2016.12.021.
12. Nguyen KM, Hoang SV. Prevalence of genetically diagnosed familial hypercholesterolemia in Vietnamese patients with premature acute myocardial infarction. Medicine. Sep 27 2024; 103(39): e39939. doi:10.1097/md.0000000000039939.
13. Rizos CV, Elisaf MS, Skoumas I, et al. Characteristics and management of 1093 patients with clinical diagnosis of familial hypercholesterolemia in Greece: Data from the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Atherosclerosis. Oct 2018; 277: 308-313. doi:10.1016/j.atherosclerosis.2018.08.017.
14. Watts GF, Gidding SS, Mata P, et al. Familial hypercholesterolaemia: evolving knowledge for designing adaptive models of care. Nature reviews Cardiology. Jun 2020; 17(6): 360-377. doi:10.1038/s41569-019-0325-8.
15. Vu THL, Bui TTQ, Tran QB, et al. Comorbidities of diabetes and hypertension in Vietnam: current burden, trends over time, and correlated factors. BMC public health. Dec 5 2023; 23(1): 2419. doi:10.1186/s12889-023-17383-z.
16. Pham T, Bui L, Giovannucci E, et al. Prevalence of obesity and abdominal obesity and their association with metabolic-related conditions in Vietnamese adults: an analysis of Vietnam STEPS survey 2009 and 2015. The Lancet regional health Western Pacific. Oct 2023; 39: 100859. doi:10.1016/j.lanwpc.2023.100859.
17. Association of BMI, lipid-lowering medication, and age with prevalence of type 2 diabetes in adults with heterozygous familial hypercholesterolaemia: a worldwide cross-sectional study. The lancet Diabetes & endocrinology. Nov 2024; 12(11): 811-823. doi:10.1016/s2213-8587(24)00221-3.
18. Van Minh H, Giang KB, Ngoc NB, et al. Prevalence of tobacco smoking in Vietnam: findings from the Global Adult Tobacco Survey 2015. International journal of public health. Feb 2017; 62(Suppl 1): 121-129. doi:10.1007/s00038-017-0955-8.
19. Kramer A, Jansen AC, van Aalst-Cohen ES, Tanck MW, Kastelein JJ, Zwinderman AH. Relative risk for cardiovascular atherosclerotic events after smoking cessation: 6-9 years excess risk in individuals with familial hypercholesterolemia. BMC public health. Oct 23 2006; 6:262. doi:10.1186/1471-2458-6-262.
20. Luirink IK, Wiegman A, Kusters DM, et al. 20-Year Follow-up of Statins in Children with Familial Hypercholesterolemia. The New England journal of medicine. Oct 17 2019; 381(16): 1547-1556. doi:10.1056/NEJMoa1816454.
2. Nordestgaard BG, Chapman MJ, Humphries SE, et al. Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. European heart journal. Dec 2013; 34(45): 3478-90a. doi:10.1093/eurheartj/eht273.
3. Risk of fatal coronary heart disease in familial hypercholesterolaemia. Scientific Steering Committee on behalf of the Simon Broome Register Group. BMJ (Clinical research ed). Oct 12 1991; 303(6807): 893-6. doi:10.1136/bmj.303.6807.893.
4. Sijbrands EJ, Westendorp RG, Defesche JC, de Meier PH, Smelt AH, Kastelein JJ. Mortality over two centuries in large pedigree with familial hypercholesterolaemia: family tree mortality study. BMJ (Clinical research ed). Apr 28 2001; 322(7293): 1019-23. doi:10.1136/bmj.322.7293.1019.
5. Vaduganathan M, Mensah GA, Turco JV, Fuster V, Roth GA. The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health. Journal of the American College of Cardiology. Dec 20 2022; 80(25): 2361-2371. doi:10.1016/j.jacc.2022.11.005.
6. Vlad CE, Foia L, Florea L, et al. Evaluation of cardiovascular risk factors in patients with familial hypercholesterolemia from the North-Eastern area of Romania. Lipids in health and disease. Jan 11 2021; 20(1): 4. doi:10.1186/s12944-020-01428-y.
7. Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). Lancet (London, England). Nov 6 2021; 398(10312): 1713-1725. doi:10.1016/s0140-6736(21)01122-3.
8. Wiegman A, Gidding SS, Watts GF, et al. Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment. European heart journal. Sep 21 2015; 36(36):2425-37. doi:10.1093/eurheartj/ehv157
9. Cao YX, Wu NQ, Sun D, et al. Application of expanded genetic analysis in the diagnosis of familial hypercholesterolemia in patients with very early-onset coronary artery disease. Journal of translational medicine. Dec 10 2018; 16(1):345. doi:10.1186/s12967-018-1737-7.
10. Corral P, Geller AS, Polisecki EY, et al. Unusual genetic variants associated with hypercholesterolemia in Argentina. Atherosclerosis. Oct 2018; 277: 256-261. doi:10.1016/j.atherosclerosis.2018.06.009.
11. Durst R, Ibe UK, Shpitzen S, et al. Molecular genetics of familial hypercholesterolemia in Israel-revisited. Atherosclerosis. Feb 2017; 257: 55-63. doi:10.1016/j.atherosclerosis.2016.12.021.
12. Nguyen KM, Hoang SV. Prevalence of genetically diagnosed familial hypercholesterolemia in Vietnamese patients with premature acute myocardial infarction. Medicine. Sep 27 2024; 103(39): e39939. doi:10.1097/md.0000000000039939.
13. Rizos CV, Elisaf MS, Skoumas I, et al. Characteristics and management of 1093 patients with clinical diagnosis of familial hypercholesterolemia in Greece: Data from the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). Atherosclerosis. Oct 2018; 277: 308-313. doi:10.1016/j.atherosclerosis.2018.08.017.
14. Watts GF, Gidding SS, Mata P, et al. Familial hypercholesterolaemia: evolving knowledge for designing adaptive models of care. Nature reviews Cardiology. Jun 2020; 17(6): 360-377. doi:10.1038/s41569-019-0325-8.
15. Vu THL, Bui TTQ, Tran QB, et al. Comorbidities of diabetes and hypertension in Vietnam: current burden, trends over time, and correlated factors. BMC public health. Dec 5 2023; 23(1): 2419. doi:10.1186/s12889-023-17383-z.
16. Pham T, Bui L, Giovannucci E, et al. Prevalence of obesity and abdominal obesity and their association with metabolic-related conditions in Vietnamese adults: an analysis of Vietnam STEPS survey 2009 and 2015. The Lancet regional health Western Pacific. Oct 2023; 39: 100859. doi:10.1016/j.lanwpc.2023.100859.
17. Association of BMI, lipid-lowering medication, and age with prevalence of type 2 diabetes in adults with heterozygous familial hypercholesterolaemia: a worldwide cross-sectional study. The lancet Diabetes & endocrinology. Nov 2024; 12(11): 811-823. doi:10.1016/s2213-8587(24)00221-3.
18. Van Minh H, Giang KB, Ngoc NB, et al. Prevalence of tobacco smoking in Vietnam: findings from the Global Adult Tobacco Survey 2015. International journal of public health. Feb 2017; 62(Suppl 1): 121-129. doi:10.1007/s00038-017-0955-8.
19. Kramer A, Jansen AC, van Aalst-Cohen ES, Tanck MW, Kastelein JJ, Zwinderman AH. Relative risk for cardiovascular atherosclerotic events after smoking cessation: 6-9 years excess risk in individuals with familial hypercholesterolemia. BMC public health. Oct 23 2006; 6:262. doi:10.1186/1471-2458-6-262.
20. Luirink IK, Wiegman A, Kusters DM, et al. 20-Year Follow-up of Statins in Children with Familial Hypercholesterolemia. The New England journal of medicine. Oct 17 2019; 381(16): 1547-1556. doi:10.1056/NEJMoa1816454.