Familial hypercholesterolaemia and coronary risk factors among patients with angiogram-proven premature coronary artery disease in an Asian cohort

• Published in: PloS one 2022-09, Vol.17 (9), p.e0273896
• Main Authors: Nazli, Sukma Azureen, Chua, Yung-An, Mohd Kasim, Noor Alicezah, Ismail, Zaliha, Md Radzi, Ahmad Bakhtiar, Ibrahim, Khairul Shafiq, Kasim, Sazzli Shahlan, Rosman, Azhari, Nawawi, Hapizah
• Format: Article
• Language: English
• Subjects: Age; Angiography; Biology and Life Sciences; Biometrics; Blood pressure; Body mass index; Cardiology; Cardiovascular disease; Cholesterol; Cholesterol, LDL; Clinics; Complications and side effects; Coronary artery; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary heart disease; Coronary vessels; Diabetes; Diabetes mellitus; Diagnosis; Disease prevention; Distribution; Genetics; Health risks; Heart diseases; High density lipoprotein; Humans; Hypercholesterolemia; Hyperlipoproteinemia Type II - complications; Hyperlipoproteinemia Type II - diagnosis; Hyperlipoproteinemia Type II - epidemiology; Hypertension; Hypertension - complications; Hypertension - epidemiology; Lipids; Lipoproteins; Male; Males; Medical imaging; Medical records; Medical screening; Medicine and Health Sciences; Methods; Middle Aged; Obesity; Patients; Population studies; Prevalence; Risk analysis; Risk Factors; Risk management; Vein & artery diseases; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0273896

Familial hypercholesterolaemia (FH) patients have elevated levels of low-density lipoprotein cholesterol, rendering them at high risk of premature coronary artery disease (PCAD). However, the FH prevalence among angiogram-proven PCAD (AP-PCAD) patients and their status of coronary risk factors (CRFs) have not been reported in the Asian population. This study aimed to (1) determine the prevalence of clinically diagnosed FH among AP-PCAD patients, (2) compare CRFs between AP-PCAD patients with control groups, and (3) identify the independent predictors of PCAD. AP-PCAD patients and FH patients without PCAD were recruited from Cardiology and Specialist Lipid Clinics. Subjects were divided into AP-PCAD with FH (G1), AP-PCAD without FH (G2), FH without PCAD (G3) and normal controls (G4). Medical records were collected from the clinic database and standardised questionnaires. FH was clinically diagnosed using Dutch Lipid Clinic Network Criteria. A total of 572 subjects were recruited (males:86.4%; mean±SD age: 55.6±8.5years). The prevalence of Definite, Potential and All FH among AP-PCAD patients were 6%(19/319), 16% (51/319) and 45.5% (145/319) respectively. G1 had higher central obesity, family history of PCAD and family history of hypercholesterolaemia compared to other groups. Among all subjects, diabetes [OR(95% CI): 4.7(2.9,7.7)], hypertension [OR(95% CI): 14.1(7.8,25.6)], FH [OR(95% CI): 2.9(1.5,5.5)] and Potential (Definite and Probable) FH [OR(95% CI): 4.5(2.1,9.6)] were independent predictors for PCAD. Among FH patients, family history of PCAD [OR(95% CI): 3.0(1.4,6.3)] and Definite FH [OR(95% CI): 7.1(1.9,27.4)] were independent predictors for PCAD. Potential FH is common among AP-PCAD patients and contributes greatly to the AP-PCAD. FH-PCAD subjects have greater proportions of various risk factors compared to other groups. Presence of FH, diabetes, hypertension, obesity and family history of PCAD are independent predictors of PCAD. FH with PCAD is in very-high-risk category, hence, early management of modifiable CRFs in these patients are warranted.