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 |
| Externí odkaz: |
|