Frequency of familial hypercholesterolemia in patients with early-onset coronary artery disease admitted to a coronary care unit.
BACKGROUND
Familial hypercholesterolemia (FH) is the most common dominantly inherited cause of premature coronary artery disease (CAD). However, the diagnosis of FH in patients who have premature CAD in hospital settings is under-recognized, this also represents a missed opportunity for screening their close family members and implementing primary prevention.


OBJECTIVE
To investigate the point prevalence of FH in a coronary care unit (CCU) among patients with early-onset CAD.


METHODS
The prevalence of FH, based on modified phenotypic Dutch Lipid Clinic Network Criteria, and the spectrum of associated CAD risk factors, were investigated in a CCU setting. Data were collected on 175 coronary care patients with onset of CAD at age <60 years.


RESULTS
The prevalence of probable/definite FH was 14.3% (95% confidence interval, 9.0%-19.5%); 46.3% of the patients gave a family history of premature CAD and 20.6% had an untreated low-density lipoprotein cholesterol >5.0 mmol/L. Diabetes, hypertension, obesity, and smoking were common and equally prevalent in patients with and without FH.


CONCLUSIONS
FH is relatively frequent among patients with a history of early-onset CAD in the CCU. Every effort should be made to detect FH in these patients and to initiate cascade testing of available family members to prevent the development of CAD in those who may be unaware that they also have the condition.
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia.
Jing
J
Pang
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia.
Elissa B
EB
Poulter
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, Western Australia, Australia; Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital, Western Australia, Australia.
Damon A
DA
Bell
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, Western Australia, Australia.
Timothy R
TR
Bates
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia.
Vicki-Lee
VL
Jefferson
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Western Australia, Australia.
Graham S
GS
Hillis
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Department of Cardiology, Royal Perth Hospital, Western Australia, Australia.
Carl J
CJ
Schultz
School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia; Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, Western Australia, Australia. Electronic address: gerald.watts@uwa.edu.au.
Gerald F
GF
Watts
D003324:Coronary Artery Disease / Q000150:complications* / Q000628:therapy*; D003325:Coronary Care Units; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006938:Hyperlipoproteinemia Type II / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D015995:Prevalence; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Coronary care unit; Familial hypercholesterolemia; Prevalence; Screening