Cardiovascular disease and mortality in statin-treated patients with familial hypercholesterolemia

• Published in: Atherosclerosis Vol. 172; no. 2; pp. 329 - 335
• Main Authors: Mohrschladt, M.F, Westendorp, R.G.J, Gevers Leuven, J.A, Smelt, A.H.M
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01-02-2004; Elsevier
• Subjects: Adult; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Familial hypercholesterolemia; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hyperlipoproteinemia Type I - drug therapy; Male; Medical sciences; Middle Aged; Mortality; Myocardial Ischemia - epidemiology; Myocardial Ischemia - mortality; Prognosis; Prospective follow-up; Statins; Cardiovascular disease; Familial hypercholesterolemia; Mortality; Statins; Prospective follow-up; Human; Premature; Nervous system diseases; Middle age; Metabolic diseases; Lipids; Hyperlipoproteinemia; Statin derivative; Lipoprotein; Cholesterol; Vascular disease; Hypercholesterolemia; Treatment; Ischemia; Heart disease; Atherosclerosis; Risk factor; Dyslipemia
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2003.11.007

Patients with familial hypercholesterolemia (FH) are at an increased risk of premature cardiovascular disease (CVD). The benefits of statin therapy are not well known since no placebo controlled studies have been performed in these patients. The aim of this study was to determine the CVD event and mortality risk in statin-treated patients with FH. A total of 345 FH patients were followed prospectively for 8 years. Mortality from CVD was compared to that of the general population.
The absolute risk of CVD in patients without a previous history of CVD was 3% per year for men and 1.6% for women. Mortality from CVD in patients without a previous history was 1.4-fold (95% CI=0.6–3.3) increased and ischaemic heart disease (IHD) mortality was 2.6-fold (95% CI=1.1–6.3) higher compared to the general population. This mortality risk was highest in patients aged 40–59 years. Female FH patients had no increased CVD or IHD mortality risk.
Over a period of 8 years the event risk of patients with a history of CVD was almost 30% per year under age 40 years and 15% in patients aged 60 years and over.
When compared to the general population, mortality from other causes than CVD was lower for patients with FH, the relative risks not reaching statistical significance. The relative risk of mortality from all causes was 1.5 (
P<0.05) for men and 1.0 for women.
In conclusion, male patients with FH, treated from middle-age with statins remain at an increased risk of developing CVD.