title: CT coronary plaque burden in asymptomatic patients with familial hypercholesterolaemia.
abstract: OBJECTIVE
  To determine the calcium score and coronary plaque burden in asymptomatic statin-treated patients with heterozygous familial hypercholesterolaemia (FH) compared with a control group of patients with low probability of coronary artery disease, having non-anginal chest pain, using CT.
  
  
  METHODS
  101 asymptomatic patients with FH (mean age 53 ± 7 years; 62 men) and 126 patients with non-anginal chest pain (mean age 56 ± 7 years; 80 men) underwent CT calcium scoring and CT coronary angiography. All patients with FH were treated with statins during a period of 10 ± 8 years before CT. The coronary calcium score and plaque burden were determined and compared between the two patient groups.
  
  
  RESULTS
  The median total calcium score was significantly higher in patients with FH (Agatston score = 87, IQR 5-367) than in patients with non-anginal chest pain (Agatston score = 7, IQR 0-125; p < 0.001). The overall coronary plaque burden was significantly higher in patients with FH (p < 0.01). Male patients with FH, whose low-density lipoprotein cholesterol levels were reduced by statins below 3.0 mmol/l, had significantly less coronary calcium (p < 0.01) and plaque burden (p = 0.02).
  
  
  CONCLUSIONS
  The coronary plaque burden is high in asymptomatic middle-aged patients with FH despite intense statin treatment.
authors.affiliation: Department of Radiology and Cardiology, Erasmus Medical Center Rotterdam, CA, Rotterdam, The Netherlands. l.neefjes@erasmusmc.nl
authors.forename: Lisan A
authors.initials: LA
authors.lastname: Neefjes
authors.forename: Gert-Jan R
authors.initials: GJ
authors.lastname: Ten Kate
authors.forename: Alexia
authors.initials: A
authors.lastname: Rossi
authors.forename: Annette J
authors.initials: AJ
authors.lastname: Galema-Boers
authors.forename: Janneke G
authors.initials: JG
authors.lastname: Langendonk
authors.forename: Annick C
authors.initials: AC
authors.lastname: Weustink
authors.forename: Adriaan
authors.initials: A
authors.lastname: Moelker
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.forename: Nico R
authors.initials: NR
authors.lastname: Mollet
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Sijbrands
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
mesh_terms: D058070:Asymptomatic Diseases; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006938:Hyperlipoproteinemia Type II / Q000150:complications* / Q000188:drug therapy / Q000235:genetics; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors