title: Carotid artery plaques and intima medial thickness in familial hypercholesteraemic patients on long-term statin therapy: A case control study.
abstract: Statins reduce subclinical atherosclerosis and premature atherosclerotic cardiovascular disease (ASCVD) in patients with familial hypercholesterolemia (FH). However, some FH patients still develop ASCVD despite statin therapy. We compared subclinical atherosclerosis assessed by carotid plaque presence and intima media thickness (C-IMT), in long-term statin-treated FH patients and healthy controls. Furthermore, we analysed whether carotid ultrasonography findings associated with subclinical coronary atherosclerosis.
  
  
  
  We assessed the presence of carotid plaques and C-IMT in 221 asymptomatic heterozygous FH patients (48% men; 46 ± 15 years) on long-term (10.0 ± 7.8 years) statin treatment and 103 controls (32% men, 47 ± 16 years).
  
  
  
  The frequency of carotid plaques and C-IMT did not differ significantly between the FH patients and controls (69 (31%) versus 24 (23%), p = 0.1 and 0.58 ± 0.13 versus 0.58 ± 0.12 mm, p = 0.9, respectively). In a subgroup of 49 FH patients who underwent cardiac computed tomography, coronary artery calcification correlated with carotid plaque presence (R = 0.47; p = 0.001), but not with C-IMT (R = 0.20; p = 0.2).
  
  
  
  Carotid plaques and C-IMT did not differ between long-term statin-treated heterozygous FH patients and healthy controls. This shows that long-term statin treatment in these FH patients reduces carotid atherosclerosis to a degree of a healthy population. These findings strongly suggests that sonography of the carotid arteries during follow-up of statin-treated FH patients has limited value.
authors.affiliation: Department of Internal Medicine, Division Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Sven
authors.initials: S
authors.lastname: Bos
authors.affiliation: Department of Internal Medicine, Division Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Martijne H C
authors.initials: MH
authors.lastname: Duvekot
authors.affiliation: Department of Cardiology, Thorax Centre Rotterdam, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Gert-Jan R
authors.initials: GR
authors.lastname: Ten Kate
authors.affiliation: Department of Internal Medicine, Division Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Adrie J M
authors.initials: AJ
authors.lastname: Verhoeven
authors.affiliation: Department of Internal Medicine, Division Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Monique T
authors.initials: MT
authors.lastname: Mulder
authors.affiliation: Department of Cardiology, Thorax Centre Rotterdam, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Arend F L
authors.initials: AF
authors.lastname: Schinkel
authors.affiliation: Department of Cardiology, Thorax Centre Rotterdam, Erasmus MC, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.affiliation: Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Watts
authors.affiliation: Department of Internal Medicine, Division Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Eric J G
authors.initials: EJ
authors.lastname: Sijbrands
authors.affiliation: Department of Internal Medicine, Division Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam, The Netherlands. Electronic address: j.roetersvanlennep@erasmusmc.nl.
authors.forename: Jeanine E
authors.initials: JE
authors.lastname: Roeters van Lennep
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000235:genetics / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D000072226:Computed Tomography Angiography; 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 / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000235:genetics
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Carotid intima media thickness; Carotid plaque presence; Familial hypercholesterolemia; Residual risk