21. Atherosclerotic cardiovascular diseases and risk factors in individuals with familial hypercholesterolemia
Main Article Content
Abstract
This cross-sectional study aimed to characterize cardiovascular risk factors and their relationships on atherosclerotic cardiovascular disease (ASCVD) in patients with familial hypercholesterolemia (FH) by analyzing data from 110 FH patients in Vietnam. Results indicated that the average age at FH diagnosis is 51.8 years old, with a prevalence of premature coronary artery disease (CAD) as 35.5%. The prevalence of smoking, overweight/obesity, hypertension, and diabetes among patients was 43.6%, 43.6%, 37.3%, and 5.5%, respectively. Notably, smoking was significantly associated with CAD and premature CAD, with Odds Ratios of 4.1 and 5.4, respectively. In conclusion, this study highlights the late diagnosis of FH in Vietnam, where many patients present with ASCVD and coexisting risk factors that exacerbate atherosclerosis. This underscores the urgent need for early screening, diagnosis, and intervention programs for FH in Vietnam.
Article Details
Keywords
Familial hypercholesterolemia, risk factor, atherosclerotic cardiovascular disease
References
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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.
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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.