Familial Hypercholesterolemia Clinical Trial
Official title:
Cardiovascular Disease in FH Heterozygous
The objective of this project is to establish the current prevalence of cardiovascular disease in adult subjects suffering from genetically diagnosed HF, and to know the impact that drug treatment has course in cardiovascular disease when compared with that of their affected parents with a much longer period of exposure to hypercholesterolemia
Familial hypercholesterolemia (FH) is the most common autosomal dominant disease in most
countries, including Spain. Its prevalence is estimated at one in every 350-500 people being
higher in certain areas with certain genetic isolation as French Canadians, Christian
Lebanese, or "Afrikaners" in South Africa. The HF is characterized by a very high
concentration of LDL cholesterol, familial autosomal dominant pattern, tendon xanthomas and
increased risk of premature coronary disease. Without drug treatment, approximately 50% of
men before age 50 years and the same percentage in women before age 60 will suffer a serious
manifestation of cardiovascular disease. It has been estimated that HF limits life
expectancy about 20 years for males and about 12 years for women, so that effective
treatment is a priority in cardiovascular prevention. Most cases of HF are caused by
mutations in the gene encoding the receptor of LDL particles (LDLR). More than 1000
different mutations in the LDLR gene (LDLR) have been described as the cause of HF, many of
them specific to a territory or population group. In Spain we have described 235 different
mutations and is one of the best studied populations in the world from the genetic point of
view. This is because in Spain we have an efficient tool for genetic diagnosis of HF,
referred Lipochip ® (Progenika Biopharma, Derio, Vizcaya), and allows us to be pioneers in
the world in the diagnosis and treatment of HF.
Most cases of HF in Spain, and especially the cases with a genetic diagnosis, which
represents the true diagnosis, are controlled by the Lipid Unit network of the Spanish
Atherosclerosis Society (SEA) distributed throughout the national territory, and in many
cases using homogeneous clinical criteria for the clinical management of these patients. For
the above reasons the SEA is the ideal setting for studies in a wide range of subjects with
HF, especially those requiring an accurate diagnosis. The advent of statins has been a
landmark for people suffering from HF. Since the late 80s of last century we have this class
of drugs. They have reduced and almost normalized LDL concentrations in FH and have
substantively altered the natural progression of the disease. However, the health impact
brought about by the statins in HF is unknown. Indirect data from the UK Simon Broome
Register suggest that subjects with HF now have a better prognosis than 20 years ago but
that register has many limitations that make difficult to know the real impact of the
treatment.
Retrospective, obervacional, multicenter, based on Lipid Units of the Sociedad Española de
Arteriosclerosis.
Our hypothesis is that statins have improved cardiovascular prognosis in recent years in
heterozygous FH subjects. The objective of this project is to establish the current
prevalence of cardiovascular disease in adult subjects suffering from genetically diagnosed
HF, and to know the impact that drug treatment has course in cardiovascular disease when
compared with that of their affected parents with a much longer period of exposure to
hypercholesterolemia.
To establish the current prevalence of cardiovascular disease in adult subjects suffering
from genetically diagnosed HF
To know the impact that drug treatment has resulted in cardiovascular disease when compared
with that of their affected parents with a longer period of exposure to
hypercholesterolemia.
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Observational Model: Case Control, Time Perspective: Retrospective
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