eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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5/2018
vol. 14
 
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abstract:
Clinical research

Clinical management of heterozygous familial hypercholesterolemia in a Polish outpatient metabolic clinic: a retrospective observational study

Longina Kłosiewicz-Latoszek, Barbara Cybulska, Janina Białobrzeska-Paluszkiewicz, Anna Jagielska, Jolanta Janowska, Dorota Danowska, Anna Reguła, Małgorzata Stroniawska-Woźniak

Arch Med Sci 2018; 14, 5: 962–970
Online publish date: 2017/11/30
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Introduction
There are currently no reports available from a Polish clinical practice on heterozygous familial hypercholesterolemia (HeFH) management. The aim of this study was to test the efficacy of HeFH hypolipidemic treatment in a Polish outpatient metabolic clinic according to treatment targets outlined in the European Atherosclerosis Society (EAS) and European Society of Cardiology (ESC) guidelines.

Material and methods
This retrospective, observational study was performed on HeFH patients who attended their routine follow-up visits in the metabolic outpatient clinic in the period between April and September 2016. According to EAS/ESC guidelines, the goal and intensity of therapy were assigned individually for every patient based on cardiovascular (CV) risk (high or very high). The treatment target was achievement of low-density lipoprotein cholesterol (LDL-C) levels < 1.8 mmol/l for very high CV risk patients and < 2.6 mmol/l for high CV risk patients. A ≥ 50% decrease in LDL-C over the observation period was an additional outcome measure.

Results
In the overall group of 222 HeFH patients (mean age: 55.2 16.2 years, 72% women), LDL-C levels decreased on average by 52.6% (p < 0.001). More than half of the patients were treated with the maximum tolerated dose of statins. A total of 25.2% of patients attained target levels of LDL-C and 55.9% attained a ≥ 50% reduction in its concentration. Despite therapy, significantly elevated post-follow-up levels of LDL-C (> 4.1 mmol/l) remained in 14% of all patients.

Conclusions
Hypolipidemic therapy according to EAS/ESC guidelines was suboptimal for a significant number of HeFH patients. Additional clinical management should be considered.

keywords:

familial hypercholesterolemia, outpatient clinic, lipid-lowering therapy, efficacy

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