Prevalence and determinants of coronary artery disease in males and females with familial combined hyperlipidaemia.
BACKGROUND
Familial combined hyperlipidaemia (FCH) is an inherited dyslipidaemia that is related to a high risk of coronary artery disease (CAD). We evaluated the prevalence of CAD in a large FCH population and the association of risk factors with CAD according to gender.


METHODS
In this single-center, observational study, lipid and lipoprotein variables were measured in untreated patients with FCH (565 males and 302 females). CAD was defined as a documented history of myocardial infarction or coronary revascularization, or an abnormal coronary angiogram (stenosis of >50% in an epicardial coronary artery), or angina plus abnormal imaging stress test.


RESULTS
Males had higher triglyceride level (P<0.001) but lower total cholesterol (P<0.001) and HDL-cholesterol level (P<0.001) compared to women. The prevalence of CAD was 22.2% in men and 4.6% in women (P<0.001). In logistic regression analysis, male gender was associated with a higher risk of CAD independent of lipid parameters and other risk factors (adjusted ORs for CAD 9.4, P<0.001). In gender-specific analysis, age (OR=1.06 per 1-year increase, P<0.001), diabetes (OR=2.42, P<0.01) and Lp(a) (OR=1.09 per 1-mg/dL increase, P<0.01) were independent predictors of CAD in men. In women, age (OR=1.24, P<0.01), total cholesterol (OR=1.022 per 1-mg/dL increase, P<0.05) and fasting glucose (OR=1.031 per 1-mg/dL increase, P<0.05) were independently associated with CAD.


CONCLUSIONS
In FCH patients, the prevalence of CAD is higher in males than in females, independent of lipidaemic profile and other risk factors. Among lipid variables, Lp(a) and cholesterol level are predictors of CAD in males and females respectively.
Pitsavos
Christos
C
1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
Skoumas
Ioannis
I
Masoura
Constantina
C
Aznaouridis
Konstantinos
K
Papadimitriou
Lambros
L
Chrysohoou
Christina
C
Giotsas
Nikolaos
N
Toutouza
Marina
M
Stefanadis
Christodoulos
C
D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000097:blood* / Q000150:complications; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL