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LDL cholesterol targets rarely achieved in familial hypercholesterolemia patients: A sex and gender-specific analysis
Despite lipid lowering therapy (LLT), reaching LDL-C targets in patients with familial hypercholesterolemia (FH) remains challenging. Our aim was to determine attainment of LDL-C target levels and reasons for not reaching these in female and male FH patients. We performed a cross-sectional study of...
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| Published in: | Atherosclerosis 2023-11, Vol.384, p.117117-117117, Article 117117 |
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| container_title | Atherosclerosis |
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| creator | Schreuder, M.M. Hamkour, S. Siegers, K.E. Holven, K.B. Johansen, A.K. van de Ree, M.A. Imholz, B. Boersma, E. Louters, L. Bogsrud, M.P. Retterstøl, K. Visseren, F.L.J. Roeters van Lennep, J.E. Koopal, C. |
| description | Despite lipid lowering therapy (LLT), reaching LDL-C targets in patients with familial hypercholesterolemia (FH) remains challenging. Our aim was to determine attainment of LDL-C target levels and reasons for not reaching these in female and male FH patients.
We performed a cross-sectional study of heterozygous FH patients in five hospitals in the Netherlands and Norway. Clinical characteristics and information about LLT, lipid levels and reasons for not being on LDL-C treatment target were retrospectively collected from electronic medical records.
We studied 3178 FH patients (53.9% women), median age 48.0 (IQR 34.0–59.9) years. Median LDL-C before treatment and on-treatment was higher in women compared to men (6.2 (IQR 5.1–7.3) and 6.0 (IQR 4.9–7.2) mmol/l (p=0.005) and 3.0 (IQR 2.4–3.8) and 2.8 (IQR 2.3–3.5) mmol/L (p |
| doi_str_mv | 10.1016/j.atherosclerosis.2023.03.022 |
| format | article |
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We performed a cross-sectional study of heterozygous FH patients in five hospitals in the Netherlands and Norway. Clinical characteristics and information about LLT, lipid levels and reasons for not being on LDL-C treatment target were retrospectively collected from electronic medical records.
We studied 3178 FH patients (53.9% women), median age 48.0 (IQR 34.0–59.9) years. Median LDL-C before treatment and on-treatment was higher in women compared to men (6.2 (IQR 5.1–7.3) and 6.0 (IQR 4.9–7.2) mmol/l (p=0.005) and 3.0 (IQR 2.4–3.8) and 2.8 (IQR 2.3–3.5) mmol/L (p<0.001)), respectively. A minority of women (26.9%) and men (28.9%) reached LDL-C target. In patients with CVD, 17.2% of women and 25.8% of men reached LDL-C target. Women received less often high-intensity statins and ezetimibe. Most common reported reasons for not achieving the LDL-C target were insufficient effect of maximum LLT (women 17.3%, men 24.3%) and side effects (women 15.2%, men 8.6%).
In routine practice, only a minority of women and men with FH achieved their LDL-C treatment target. Extra efforts have to be made to provide FH patients with reliable information on the safety of statins and their long-term effects on CVD risk reduction. If statin treatment is insufficient, alternative lipid lowering therapies such as ezetimibe or PCSK9-inhibitors should be considered.
[Display omitted]
•A minority of women and men with FH reach their LDL-C targets.•-•Women received less often high-intensity statins and ezetimibe.•Women had higher LDL-C before treatment.•Women reported to have more side effects than men.•Alternative LLT should be considered in women and men not reaching LDL-C target.</description><identifier>ISSN: 0021-9150</identifier><identifier>EISSN: 1879-1484</identifier><identifier>DOI: 10.1016/j.atherosclerosis.2023.03.022</identifier><identifier>PMID: 37080805</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Familial hypercholesterolemia ; LDL-Cholesterol ; Lipid-lowering therapy ; PCSK9 monoclonal antibody ; Statin ; Treatment target</subject><ispartof>Atherosclerosis, 2023-11, Vol.384, p.117117-117117, Article 117117</ispartof><rights>2023 The Authors</rights><rights>Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c469t-2d6345cc5f95b84efebe016549672d27acafbf3414edcd15b30aae10cb821d153</citedby><cites>FETCH-LOGICAL-c469t-2d6345cc5f95b84efebe016549672d27acafbf3414edcd15b30aae10cb821d153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,783,787,888,26579,27936,27937</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37080805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schreuder, M.M.</creatorcontrib><creatorcontrib>Hamkour, S.</creatorcontrib><creatorcontrib>Siegers, K.E.</creatorcontrib><creatorcontrib>Holven, K.B.</creatorcontrib><creatorcontrib>Johansen, A.K.</creatorcontrib><creatorcontrib>van de Ree, M.A.</creatorcontrib><creatorcontrib>Imholz, B.</creatorcontrib><creatorcontrib>Boersma, E.</creatorcontrib><creatorcontrib>Louters, L.</creatorcontrib><creatorcontrib>Bogsrud, M.P.</creatorcontrib><creatorcontrib>Retterstøl, K.</creatorcontrib><creatorcontrib>Visseren, F.L.J.</creatorcontrib><creatorcontrib>Roeters van Lennep, J.E.</creatorcontrib><creatorcontrib>Koopal, C.</creatorcontrib><title>LDL cholesterol targets rarely achieved in familial hypercholesterolemia patients: A sex and gender-specific analysis</title><title>Atherosclerosis</title><addtitle>Atherosclerosis</addtitle><description>Despite lipid lowering therapy (LLT), reaching LDL-C targets in patients with familial hypercholesterolemia (FH) remains challenging. Our aim was to determine attainment of LDL-C target levels and reasons for not reaching these in female and male FH patients.
We performed a cross-sectional study of heterozygous FH patients in five hospitals in the Netherlands and Norway. Clinical characteristics and information about LLT, lipid levels and reasons for not being on LDL-C treatment target were retrospectively collected from electronic medical records.
We studied 3178 FH patients (53.9% women), median age 48.0 (IQR 34.0–59.9) years. Median LDL-C before treatment and on-treatment was higher in women compared to men (6.2 (IQR 5.1–7.3) and 6.0 (IQR 4.9–7.2) mmol/l (p=0.005) and 3.0 (IQR 2.4–3.8) and 2.8 (IQR 2.3–3.5) mmol/L (p<0.001)), respectively. A minority of women (26.9%) and men (28.9%) reached LDL-C target. In patients with CVD, 17.2% of women and 25.8% of men reached LDL-C target. Women received less often high-intensity statins and ezetimibe. Most common reported reasons for not achieving the LDL-C target were insufficient effect of maximum LLT (women 17.3%, men 24.3%) and side effects (women 15.2%, men 8.6%).
In routine practice, only a minority of women and men with FH achieved their LDL-C treatment target. Extra efforts have to be made to provide FH patients with reliable information on the safety of statins and their long-term effects on CVD risk reduction. If statin treatment is insufficient, alternative lipid lowering therapies such as ezetimibe or PCSK9-inhibitors should be considered.
[Display omitted]
•A minority of women and men with FH reach their LDL-C targets.•-•Women received less often high-intensity statins and ezetimibe.•Women had higher LDL-C before treatment.•Women reported to have more side effects than men.•Alternative LLT should be considered in women and men not reaching LDL-C target.</description><subject>Familial hypercholesterolemia</subject><subject>LDL-Cholesterol</subject><subject>Lipid-lowering therapy</subject><subject>PCSK9 monoclonal antibody</subject><subject>Statin</subject><subject>Treatment target</subject><issn>0021-9150</issn><issn>1879-1484</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>3HK</sourceid><recordid>eNqNUU2LFDEQDaK44-pfkFwELz0m6WS6W_CwrLorDHjRc6hOqncypD9MMovz761hdhfxJCkqJLz3KnmPsXdSrKWQmw_7NZQdpjm7eOohr5VQ9VpQKfWMrWTbdJXUrX7OVkIoWXXSiAv2Kue9EEI3sn3JLupGtLTMih22n7fc7eaIuZBe5AXSHZbMEySMRw5uF_AePQ8TH2AMMUDku-OC6S8SjgH4AiXgVPJHfsUz_uYweX6Hk8dU5QVdGIKjO4hHevNr9mKAmPHNw37Jfn798uP6ttp-v_l2fbWtnN50pVJ-U2vjnBk607caB-yRPDC62zTKqwYcDP1Qa6nROy9NXwsAlML1rZJ0ri8ZP-u6FHIJk53mBFaK1ijqTa1bgrw_Q5Y0_zrQh-wYssMYYcL5kK0im0StjBYE_fSoNueccLBLCiOkI2nZUzh2b_8Jx57CsYJKKeK_fRh16Ef0T-zHNAhwcwYgeXIfMNnsyFOHPiR0xfo5_OeoP_ZZq5o</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Schreuder, M.M.</creator><creator>Hamkour, S.</creator><creator>Siegers, K.E.</creator><creator>Holven, K.B.</creator><creator>Johansen, A.K.</creator><creator>van de Ree, M.A.</creator><creator>Imholz, B.</creator><creator>Boersma, E.</creator><creator>Louters, L.</creator><creator>Bogsrud, M.P.</creator><creator>Retterstøl, K.</creator><creator>Visseren, F.L.J.</creator><creator>Roeters van Lennep, J.E.</creator><creator>Koopal, C.</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>3HK</scope></search><sort><creationdate>20231101</creationdate><title>LDL cholesterol targets rarely achieved in familial hypercholesterolemia patients: A sex and gender-specific analysis</title><author>Schreuder, M.M. ; Hamkour, S. ; Siegers, K.E. ; Holven, K.B. ; Johansen, A.K. ; van de Ree, M.A. ; Imholz, B. ; Boersma, E. ; Louters, L. ; Bogsrud, M.P. ; Retterstøl, K. ; Visseren, F.L.J. ; Roeters van Lennep, J.E. ; Koopal, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-2d6345cc5f95b84efebe016549672d27acafbf3414edcd15b30aae10cb821d153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Familial hypercholesterolemia</topic><topic>LDL-Cholesterol</topic><topic>Lipid-lowering therapy</topic><topic>PCSK9 monoclonal antibody</topic><topic>Statin</topic><topic>Treatment target</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schreuder, M.M.</creatorcontrib><creatorcontrib>Hamkour, S.</creatorcontrib><creatorcontrib>Siegers, K.E.</creatorcontrib><creatorcontrib>Holven, K.B.</creatorcontrib><creatorcontrib>Johansen, A.K.</creatorcontrib><creatorcontrib>van de Ree, M.A.</creatorcontrib><creatorcontrib>Imholz, B.</creatorcontrib><creatorcontrib>Boersma, E.</creatorcontrib><creatorcontrib>Louters, L.</creatorcontrib><creatorcontrib>Bogsrud, M.P.</creatorcontrib><creatorcontrib>Retterstøl, K.</creatorcontrib><creatorcontrib>Visseren, F.L.J.</creatorcontrib><creatorcontrib>Roeters van Lennep, J.E.</creatorcontrib><creatorcontrib>Koopal, C.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><jtitle>Atherosclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schreuder, M.M.</au><au>Hamkour, S.</au><au>Siegers, K.E.</au><au>Holven, K.B.</au><au>Johansen, A.K.</au><au>van de Ree, M.A.</au><au>Imholz, B.</au><au>Boersma, E.</au><au>Louters, L.</au><au>Bogsrud, M.P.</au><au>Retterstøl, K.</au><au>Visseren, F.L.J.</au><au>Roeters van Lennep, J.E.</au><au>Koopal, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>LDL cholesterol targets rarely achieved in familial hypercholesterolemia patients: A sex and gender-specific analysis</atitle><jtitle>Atherosclerosis</jtitle><addtitle>Atherosclerosis</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>384</volume><spage>117117</spage><epage>117117</epage><pages>117117-117117</pages><artnum>117117</artnum><issn>0021-9150</issn><eissn>1879-1484</eissn><abstract>Despite lipid lowering therapy (LLT), reaching LDL-C targets in patients with familial hypercholesterolemia (FH) remains challenging. Our aim was to determine attainment of LDL-C target levels and reasons for not reaching these in female and male FH patients.
We performed a cross-sectional study of heterozygous FH patients in five hospitals in the Netherlands and Norway. Clinical characteristics and information about LLT, lipid levels and reasons for not being on LDL-C treatment target were retrospectively collected from electronic medical records.
We studied 3178 FH patients (53.9% women), median age 48.0 (IQR 34.0–59.9) years. Median LDL-C before treatment and on-treatment was higher in women compared to men (6.2 (IQR 5.1–7.3) and 6.0 (IQR 4.9–7.2) mmol/l (p=0.005) and 3.0 (IQR 2.4–3.8) and 2.8 (IQR 2.3–3.5) mmol/L (p<0.001)), respectively. A minority of women (26.9%) and men (28.9%) reached LDL-C target. In patients with CVD, 17.2% of women and 25.8% of men reached LDL-C target. Women received less often high-intensity statins and ezetimibe. Most common reported reasons for not achieving the LDL-C target were insufficient effect of maximum LLT (women 17.3%, men 24.3%) and side effects (women 15.2%, men 8.6%).
In routine practice, only a minority of women and men with FH achieved their LDL-C treatment target. Extra efforts have to be made to provide FH patients with reliable information on the safety of statins and their long-term effects on CVD risk reduction. If statin treatment is insufficient, alternative lipid lowering therapies such as ezetimibe or PCSK9-inhibitors should be considered.
[Display omitted]
•A minority of women and men with FH reach their LDL-C targets.•-•Women received less often high-intensity statins and ezetimibe.•Women had higher LDL-C before treatment.•Women reported to have more side effects than men.•Alternative LLT should be considered in women and men not reaching LDL-C target.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>37080805</pmid><doi>10.1016/j.atherosclerosis.2023.03.022</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Atherosclerosis, 2023-11, Vol.384, p.117117-117117, Article 117117 |
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| language | eng |
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| source | BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS; NORA - Norwegian Open Research Archives; Elsevier |
| subjects | Familial hypercholesterolemia LDL-Cholesterol Lipid-lowering therapy PCSK9 monoclonal antibody Statin Treatment target |
| title | LDL cholesterol targets rarely achieved in familial hypercholesterolemia patients: A sex and gender-specific analysis |
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