%0 Journal Article
%A Perez-de-Isla, Leopoldo
%A Alonso, Rodrigo
%A Watts, Gerald F.
%A Mata, Nelva
%A Saltijeral-Cerezo, Adriana
%A Muniz, Ovidio
%A Fuentes, Francisco
%A Diaz-Diaz, Jose Luis 
%A de-Andres, Raimundo
%A Zambon, Daniel
%A Rubio-Marin, Patricia
%A Barba-Romero, Miguel A.
%A Saenz, Pedro
%A Sanchez-Munoz-Torrero, Juan F.
%A Martinez-Faedo, Ceferino
%A Miramontes-Gonzalez, Jose P.
%A Badimon, Lina
%A Mata, Pedro
%T Attainment of LDL-Cholesterol Treatment Goals in Patients With Familial Hypercholesterolemia 5-Year SAFEHEART Registry Follow-Up
%D 2016
%@ 0735-1097
%U http://hdl.handle.net/10668/18806
%X BACKGROUND Familial hypercholesterolemia (FH) is the most common genetic disorder associated with premature atherosclerotic cardiovascular disease (ASCVD). There are sparse data on attainment of treatment targets; large registries that reflect real-life clinical practice can uniquely provide this information.OBJECTIVES We sought to evaluate the achievement of low-density lipoprotein cholesterol (LDL-C) treatment goals in FH patients enrolled in a large national registry.METHODS The SAFEHEART study (Spanish Familial Hypercholesterolemia Cohort Study) is a large, ongoing registry of molecularly defined patients with heterozygous FH treated in Spain. The attainment of guideline-recommended plasma LDL-C goals at entry and follow-up was investigated in relation to use of lipid-lowering therapy (LLT).RESULTS The study recruited 4,132 individuals (3,745 of whom were >= 18 years of age); 2,752 of those enrolled were molecularly diagnosed FH cases. Mean follow-up was 5.1 +/- 3.1 years; 71.8% of FH cases were on maximal LLT, and an LDL-C treatment target = 18 years of age); 2,752 of those enrolled were molecularly diagnosed FH cases. Mean follow-up was 5.1 +/- 3.1 years; 71.8% of FH cases were on maximal LLT, and an LDL-C treatment target <100 mg/dl was reached by only 11.2% of patients. At follow-up, there was a significant increasein the use of ezetimibe, drug combinations with statins, and maximal LLT. The presence of type 2 diabetes mellitus, adefective allele mutation, ezetimibe use, and the absence of previous ASCVD were predictors of the attainment ofLDL-C  goals. CONCLUSIONS Despite the use of intensified LLT, many FH patients continue to experience high plasma LDL-C levelsand, consequently, do not achieve recommended treatment targets. Type of LDL-receptor mutation, use of ezetimibe,coexistent diabetes, and ASCVD status can bear significantly on the likelihood of attaining LDL-C treatment goals.
%K Guidance
%K Management
%K Ezetimibe
%K Mortality
%K Efficacy
%K Therapy
%K Disease
%K Cohort
%K Risk
%K Care
%K Área de Gestión Sanitaria de Jerez, Costa Noroeste y Sierra de Cádiz
%K Cardiovascular disease
%K LDL-receptor mutations
%K Lipid-lowering therapy
%K Low-density lipoprotein cholesterol
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