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Association of peripheral arterial and cardiovascular diseases in familial hypercholesterolemia.

Pereira C, Miname M, Makdisse M, Kalil Filho R, Santos RD - Arq. Bras. Cardiol. (2014)

Bottom Line: The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively.On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049).Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD.

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração, HC, FM, USP, São Paulo, SP, Brazil.

ABSTRACT

Background: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by an elevation in the serum levels of total cholesterol and of low-density lipoproteins (LDL- c). Known to be closely related to the atherosclerotic process, FH can determine the development of early obstructive lesions in different arterial beds. In this context, FH has also been proposed to be a risk factor for peripheral arterial disease (PAD).

Objective: This observational cross-sectional study assessed the association of PAD with other manifestations of cardiovascular disease (CVD), such as coronary artery and cerebrovascular disease, in patients with heterozygous FH.

Methods: The diagnosis of PAD was established by ankle-brachial index (ABI) values ≤ 0.90. This study assessed 202 patients (35% of men) with heterozygous FH (90.6% with LDL receptor mutations), mean age of 51 ± 14 years and total cholesterol levels of 342 ± 86 mg /dL.

Results: The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively. On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049).

Conclusion: Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD. However, further studies are required to determine the role of ABI as a tool to assess the cardiovascular risk of those patients.

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Prevalence of altered ankle-brachial index (ABI) in patients with and withoutcardiovascular disease (CVD - %).
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f01: Prevalence of altered ankle-brachial index (ABI) in patients with and withoutcardiovascular disease (CVD - %).

Mentions: An ABI prevalence ≤ 0.90 was observed in 17% of the total study population, 31.6%in the group with CVD and 11.7% in the group without CVD (Figure 1). Tables 1 and 2 show the clinical and laboratory data of patientswith FH with or without ABI < 0.90. Their mean age was 51 years, and 35% were men.Total cholesterol was 342 mg/dL. It is worth emphasizing that 95% of the patientsstudied were on statins at the time of the study assessment. The prevalence of previousCVD was 28.2%. The individuals with a history of CVD had the following characteristics:older age; predominantly of the male sex; active or non-active smokers; hypertension;diabetes; higher prevalence of corneal arcus; higher diastolic bloodpressure levels; lower serum levels of HDL-c; and higher serum levels of glucose andcreatinine (p < 0.05 for all parameters). The groups did not differ regarding totalcholesterol and LDL-c levels. On univariate analysis, CVD was 3.5 times more frequentamong those with an altered ABI (p = 0.001).


Association of peripheral arterial and cardiovascular diseases in familial hypercholesterolemia.

Pereira C, Miname M, Makdisse M, Kalil Filho R, Santos RD - Arq. Bras. Cardiol. (2014)

Prevalence of altered ankle-brachial index (ABI) in patients with and withoutcardiovascular disease (CVD - %).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150662&req=5

f01: Prevalence of altered ankle-brachial index (ABI) in patients with and withoutcardiovascular disease (CVD - %).
Mentions: An ABI prevalence ≤ 0.90 was observed in 17% of the total study population, 31.6%in the group with CVD and 11.7% in the group without CVD (Figure 1). Tables 1 and 2 show the clinical and laboratory data of patientswith FH with or without ABI < 0.90. Their mean age was 51 years, and 35% were men.Total cholesterol was 342 mg/dL. It is worth emphasizing that 95% of the patientsstudied were on statins at the time of the study assessment. The prevalence of previousCVD was 28.2%. The individuals with a history of CVD had the following characteristics:older age; predominantly of the male sex; active or non-active smokers; hypertension;diabetes; higher prevalence of corneal arcus; higher diastolic bloodpressure levels; lower serum levels of HDL-c; and higher serum levels of glucose andcreatinine (p < 0.05 for all parameters). The groups did not differ regarding totalcholesterol and LDL-c levels. On univariate analysis, CVD was 3.5 times more frequentamong those with an altered ABI (p = 0.001).

Bottom Line: The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively.On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049).Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD.

View Article: PubMed Central - PubMed

Affiliation: Instituto do Coração, HC, FM, USP, São Paulo, SP, Brazil.

ABSTRACT

Background: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease characterized by an elevation in the serum levels of total cholesterol and of low-density lipoproteins (LDL- c). Known to be closely related to the atherosclerotic process, FH can determine the development of early obstructive lesions in different arterial beds. In this context, FH has also been proposed to be a risk factor for peripheral arterial disease (PAD).

Objective: This observational cross-sectional study assessed the association of PAD with other manifestations of cardiovascular disease (CVD), such as coronary artery and cerebrovascular disease, in patients with heterozygous FH.

Methods: The diagnosis of PAD was established by ankle-brachial index (ABI) values ≤ 0.90. This study assessed 202 patients (35% of men) with heterozygous FH (90.6% with LDL receptor mutations), mean age of 51 ± 14 years and total cholesterol levels of 342 ± 86 mg /dL.

Results: The prevalences of PAD and previous CVD were 17% and 28.2 %, respectively. On multivariate analysis, an independent association between CVD and the diagnosis of PAD was observed (OR = 2.50; 95% CI: 1.004 - 6.230; p = 0.049).

Conclusion: Systematic screening for PAD by use of ABI is feasible to assess patients with FH, and it might indicate an increased risk for CVD. However, further studies are required to determine the role of ABI as a tool to assess the cardiovascular risk of those patients.

Show MeSH
Related in: MedlinePlus