Key result
Coronary and carotid plaque scores were independently associated with MACEs in patients with heterozygous familial hypercholesterolemia (HR 3.33; 95% CI 1.88-4.78 and HR 2.24; 95% CI 1.28-3.20).
Why the study?
Little is known regarding the formation of coronary and carotid plaques and their impact on cardiovascular disease in patients with familial hypercholesterolemia.
Are coronary and carotid plaque scores associated with major adverse cardiac events in patients with heterozygous familial hypercholesterolemia?
Cohort (n=622)
No
Are coronary and carotid plaque scores associated with major adverse cardiac events in patients with heterozygous familial hypercholesterolemia?
Hazard Ratio: 3.33 (95% CI 1.88–4.78)
p-value: p=<0.001
Coronary and carotid plaque scores are highly correlated and independently predict major adverse cardiac events in patients with heterozygous familial hypercholesterolemia.
FH plaque imaging may refine risk stratification; leaves open whether it improves MACE prediction or alters management beyond LDL-C control.
Little is known regarding the formation of coronary and carotid plaques and their impact on cardiovascular disease in patients with familial hypercholesterolemia (FH). This study aimed to determine: 1) if the development of coronary and carotid plaques is correlated; and 2) if these plaques are associated with major adverse cardiac events (MACEs) defined as cardiovascular-related death, unstable angina, myocardial infarction, or staged revascularization. This was a retrospective review of 622 patients with heterozygous FH (HeFH) at Kanazawa University Hospital, assessed coronary and carotid plaque scores using coronary computed tomography and carotid ultrasound within 1 year. Spearman correlation coefficients were assessed among variables. Risk factors for MACEs were determined using the Cox proportional hazard model. Coronary and carotid plaque scores were significantly correlated in patients with HeFH in both sexes (Spearman’s r = 0.82; P < 0.001 in males and Spearman’s r = 0.87; P < 0.001 in females). We observed 132 MACEs during the median follow-up of 13.2 years. These scores were significantly associated with the occurrence of MACE (HR: 3.33; 95% CI: 1.88-4.78; P < 0.001, HR: 2.24; 95% CI: 1.28-3.20; P < 0.001, respectively). Coronary and carotid plaque scores were significantly correlated, and both were independently associated with MACEs. The assessments for coronary and/or carotid plaque are useful for further risk stratifications in patients with HeFH.
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Tada et al. (2023) conducted a cohort in Heterozygous familial hypercholesterolemia (n=622). Coronary and carotid plaque scores was evaluated on Major adverse cardiac events (MACEs) defined as cardiovascular-related death, unstable angina, myocardial infarction, or staged revascularization (HR 3.33, 95% CI 1.88-4.78, p=<0.001). Coronary and carotid plaque scores were independently associated with MACEs in patients with heterozygous familial hypercholesterolemia (HR 3.33; 95% CI 1.88-4.78 and HR 2.24; 95% CI 1.28-3.20).
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