Familial Hypercholesterolemia and Risk of Peripheral Arterial Disease and Chronic Kidney Disease

Autor: Marianne Benn, Frida Emanuelsson, Børge G. Nordestgaard
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Denmark
Endocrinology
Diabetes and Metabolism
Clinical Biochemistry
Population
Myocardial Infarction
Context (language use)
Familial hypercholesterolemia
030204 cardiovascular system & hematology
Biochemistry
Hyperlipoproteinemia Type II
Coronary artery disease
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
Endocrinology
Risk Factors
Internal medicine
Prevalence
medicine
Humans
Ankle Brachial Index
Prospective Studies
030212 general & internal medicine
Myocardial infarction
Renal Insufficiency
Chronic
Prospective cohort study
education
Aged
education.field_of_study
business.industry
Biochemistry (medical)
Hazard ratio
Middle Aged
medicine.disease
Cholesterol
Cross-Sectional Studies
Female
business
Follow-Up Studies
Glomerular Filtration Rate
Kidney disease
Zdroj: The Journal of Clinical Endocrinology & Metabolism. 103:4491-4500
ISSN: 1945-7197
0021-972X
DOI: 10.1210/jc.2018-01058
Popis: Context Individuals with familial hypercholesterolemia (FH) have a high risk of coronary artery disease, but their risk of peripheral arterial disease (PAD) and chronic kidney disease (CKD) is unknown. Objective In individuals with clinical FH, we tested the hypotheses (1) that the risks of PAD and CKD are elevated and (2) that low ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR) are associated with a high risk of myocardial infarction. Design and Setting Prospective cohort study of the general population. Participants A total of 106,172 individuals, of whom 7109 were diagnosed with FH. Main Outcome Measures PAD, CKD, and myocardial infarction. Results Compared with individuals with unlikely FH, multivariable adjusted ORs (95% CIs) of PAD were 1.84 (1.70 to 2.00) in those with possible FH and 1.36 (1.00 to 1.84) in individuals with probable/definite FH. For CKD, the corresponding ORs (95% CIs) were 1.92 (1.78 to 2.07) and 2.42 (1.86 to 3.26). Compared with individuals with unlikely FH and ABI >0.9, the multivariable adjusted hazard ratio (95% CI) of myocardial infarction was 4.60 (2.36 to 8.97) in those with possible/probable/definite FH and ABI ≤0.9. Compared with individuals with unlikely FH and eGFR ≥60 mL/min/1.73 m2, the corresponding value was 2.19 (1.71 to 2.82) in those with possible/probable/definite FH and eGFR Conclusions Individuals with clinical FH have increased risks of PAD and CKD, and low ABI and eGFR are associated with high risk of myocardial infarction. Consequently, individuals with FH should be screened for PAD and CKD, and ABI and eGFR may be used as prognostic tools in the management and treatment of FH to identify those at very high risk of myocardial infarction.
Databáze: OpenAIRE
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