title: Impact of cardiometabolic risk factors on major cardiovascular events in patients with familial combined hyperlipidemia.
abstract: BACKGROUND
  Familial combined hyperlipidemia (FCH) is an inherited lipid disorder associated with premature cardiovascular disease. It has not been established whether the cardiometabolic risk factors, which frequently accompany FCH, such as diabetes, metabolic syndrome (MetS) and hypertension, modulate cardiovascular risk in FCH patients.
  
  
  RESULTS
  In this single-center, retrospective study, 695 FCH patients with adequate follow-up were enrolled (mean age, 48.9 years; 455 male). Risk factors including lipid levels were evaluated before the initiation of treatment. Acute myocardial infarction (AMI) and cardiovascular death were recorded during a mean follow-up of 9 years. The combined endpoint (AMI and/or cardiovascular death) occurred in 41 patients (5.9% of the total). Those FCH patients who reached the combined endpoint had lower high-density lipoprotein cholesterol (HDL-C) than those who did not, but levels of other lipid variables were similar. Presence of hypertension, diabetes or MetS was a predictor of the combined endpoint on univariate Kaplan-Meier analysis (all P<0.005). Multivariate Cox proportional analysis showed that hypertension and MetS were associated with the combined endpoint independently of age, gender, HDL-C and presence of coronary artery disease at enrollment (adjusted hazard ratios [HRs], 3.00; 95% confidence interval [CI]: 1.46-6.17, P=0.003; HR, 2.43; 95CI%: 1.11-5.33, P=0.026, respectively).
  
  
  CONCLUSIONS
  Cardiometabolic risk factors such as hypertension and MetS are independent predictors of major cardiovascular events in FCH patients.
authors.affiliation: First Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Skoumas
authors.forename: Constantina
authors.initials: C
authors.lastname: Masoura
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Aznaouridis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Metaxa
authors.forename: Athanassios
authors.initials: A
authors.lastname: Tsokanis
authors.forename: Lambros
authors.initials: L
authors.lastname: Papadimitriou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology / Q000401:mortality; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000097:blood / Q000150:complications / Q000401:mortality; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D008076:Cholesterol, HDL