Epidemiology of atherosclerotic cardiovascular disease in polygenic hypercholesterolemia with or without high lipoprotein(a) levels.

Autor:	Vinci P; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Fiotti N; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Panizon E; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Tosoni LM; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Cerrato C; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Pellicori F; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Pirulli A; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Altamura N; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy., Schincariol P; Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Di Girolamo FG; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy.; Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy., Biolo G; U.C.O. Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste and ASUGI, Trieste, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2024 Jan 22; Vol. 10, pp. 1272288. Date of Electronic Publication: 2024 Jan 22 (Print Publication: 2023).
DOI:	10.3389/fcvm.2023.1272288
Abstrakt:	Background and Aims: Epidemiology of atherosclerotic cardiovascular disease might be different in patients with polygenic hypercholesterolemia plus high levels (≥30 mg/dl) of Lp(a) (H-Lpa) than in those with polygenic hypercholesterolemia alone (H-LDL). We compared the incidence of peripheral artery disease (PAD), coronary artery disease (CAD), and cerebrovascular disease (CVD) in patients with H-Lpa and in those with H-LDL. Methods: Retrospective analysis of demographics, risk factors, vascular events, therapy, and lipid profile in outpatient clinical data. Inclusion criteria was adult age, diagnosis of polygenic hypercholesterolemia, and both indication and availability for Lp(a) measurement. Results: Medical records of 258 patients with H-Lpa and 290 H-LDL were reviewed for occurrence of vascular events. The median duration of follow-up was 10 years (IQR 3-16). In spite of a similar reduction of LDL cholesterol, vascular events occurred more frequently, and approximately 7 years earlier ( P  = 0.024) in patients with H-Lpa than in H-LDL (HR 1.96 1.21-3.17, P  = 0.006). The difference was around 10 years for acute events (TIA, Stroke, acute coronary events) and one year for chronic ones ( P  = 0.023 and 0.525, respectively). Occurrence of acute CAD was higher in H-Lpa men (HR 3.1, 95% CI 1.2-7.9, P  = 0.007) while, among women, PAD was observed exclusively in H-Lpa subjects with smoking habits ( P  = 0.009). Conclusions: Patients with high Lp(a) levels suffer from a larger and earlier burden of the disease compared to those with polygenic hypercholesterolemia alone. These patients are at higher risk of CAD if they are men, and of PAD if they are women. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Vinci, Fiotti, Panizon, Tosoni, Cerrato, Pellicori, Pirulli, Altamura, Schincariol, Di Girolamo and Biolo.)
Databáze:	MEDLINE
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