RT Journal Article
T1 Predicting Cardiovascular Events in Familial Hypercholesterolemia: The SAFEHEART Registry (Spanish Familial Hypercholesterolemia Cohort Study).
A1 Perez de Isla, Leopoldo
A1 Alonso, Rodrigo
A1 Mata, Nelva
A1 Fernandez-Perez, Cristina
A1 Muñiz, Ovidio
A1 Diaz-Diaz, Jose Luis
A1 Saltijeral, Adriana
A1 Fuentes-Jimenez, Francisco
A1 de Andres, Raimundo
A1 Zambon, Daniel
A1 Piedecausa, Mar
A1 Cepeda, Jose Maria
A1 Mauri, Marta
A1 Galiana, Jesus
A1 Brea, Angel
A1 Sanchez Muñoz-Torrero, Juan Francisco
A1 Padro, Teresa
A1 Argueso, Rosa
A1 Miramontes-Gonzalez, Jose Pablo
A1 Badimon, Lina
A1 Santos, Raul D
A1 Watts, Gerald F
A1 Mata, Pedro
K1 Diagnostic techniques, cardiovascular
K1 Genetics
K1 Heart diseases
K1 Hypercholesterolemia
K1 Risk assessment
AB Although risk factors for atherosclerotic cardiovascular disease (ASCVD) in familial hypercholesterolemia (FH) have been described, models for predicting incident ASCVD have not been reported. Our aim was to use the SAFEHEART registry (Spanish Familial Hypercholesterolemia Cohort Study) to define key risk factors for predicting incident ASCVD in patients with FH. SAFEHEART is a multicenter, nationwide, long-term prospective cohort study of a molecularly defined population with FH with or without previous ASCVD. Analyses to define risk factors and to build a risk prediction equation were developed, and the risk prediction equation was tested for its ability to discriminate patients who experience incident ASCVD from those who did not over time. We recruited 2404 adult patients with FH who were followed up for a mean of 5.5 years (SD, 3.2 years), during which 12 (0.5%) and 122 (5.1%) suffered fatal and nonfatal incident ASCVD, respectively. Age, male sex, history of previous ASCVD, high blood pressure, increased body mass index, active smoking, and low-density lipoprotein cholesterol and lipoprotein(a) levels were independent predictors of incident ASCVD from which a risk equation with a Harrell C index of 0.85 was derived. The bootstrap resampling (100 randomized samples) of the original set for internal validation showed a degree of overoptimism of 0.003. Individual risk was estimated for each person without an established diagnosis of ASCVD before enrollment in the registry by use of the SAFEHEART risk equation, the modified Framingham risk equation, and the American College of Cardiology/American Heart Association ASCVD Pooled Cohort Risk Equations. The Harrell C index for these models was 0.81, 0.78, and 0.8, respectively, and differences between the SAFEHEART risk equation and the other 2 were significant (P=0.023 and P=0.045). The risk of incident ASCVD may be estimated in patients with FH with simple clinical predictors. This finding may improve risk stratification and could be used to guide therapy in patients with FH.
PB Lippincott Williams & Wilkins
YR 2017
FD 2017-02-24
LK http://hdl.handle.net/10668/10945
UL http://hdl.handle.net/10668/10945
LA en
NO Pérez de Isla L, Alonso R, Mata N, Fernández-Pérez C, Muñiz O, Díaz-Díaz JL, et al. Predicting Cardiovascular Events in Familial Hypercholesterolemia: The SAFEHEART Registry (Spanish Familial Hypercholesterolemia Cohort Study). Circulation. 2017 May 30;135(22):2133-2144
DS RISalud
RD Apr 12, 2025