Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry

Christos V. Rizos; Matilda Florentin; Ioannis Skoumas; Konstantinos Tziomalos; Loukianos Rallidis; Vasileios Kotsis; Vasileios Athyros; Emmanouil Skalidis; Genovefa Kolovou; Anastasia Garoufi; Eleni Bilianou; Iosif Koutagiar; Dimitrios Agapakis; Estela Kiouri; Christina Antza; Niki Katsiki; Evangelos Zacharis; Achilleas Attilakos; George Sfikas; Panagiotis Anagnostis; Demosthenes B. Panagiotakos; Evangelos N. Liberopoulos

doi:10.1186/s12944-020-01289-5

Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry

Christos V. Rizos
, Matilda Florentin
, Ioannis Skoumas
, Konstantinos Tziomalos
, Loukianos Rallidis
, Vasileios Kotsis
, Vasileios Athyros
, Emmanouil Skalidis
, Genovefa Kolovou
, Anastasia Garoufi
, Eleni Bilianou
, Iosif Koutagiar
, Dimitrios Agapakis
, Estela Kiouri
, Christina Antza
, Niki Katsiki
, Evangelos Zacharis
, Achilleas Attilakos
, George Sfikas
, Panagiotis Anagnostis

Demosthenes B. Panagiotakos, Evangelos N. Liberopoulos

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

3 Downloads (Pure)

Abstract

Background: Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed. Methods: Patients with FH were recruited by a network of Greek sites participating in the HELLAS-FH registry. LDL-C levels were calculated using the Friedewald (LDL-C_F) and the Martin/Hopkins (LDL-C_M/H) equations as well as after correcting LDL-C_M/H for Lp(a) levels [LDL-C_Lp(a)corM/H]. The objective was to compare LDL-C levels and target achievement as estimated by different methods in FH patients. Results: This analysis included 1620 patients (1423 adults and 197 children). In adults at diagnosis, LDL-C_F and LDL-C_M/H levels were similar [235 ± 70 mg/dL (6.1 ± 1.8 mmol/L) vs 235 ± 69 mg/dL (6.1 ± 1.8 mmol/L), respectively; P = NS], while LDL-C_Lp(a)corM/H levels were non-significantly lower than LDL-C_F [211 ± 61 mg/dL (5.5 ± 1.6 mmol/L); P = 0.432]. In treated adults (n = 966) both LDL-C_F [150 ± 71 mg/dL (3.9 ± 1.8 mmol/L)] and LDL-C_M/H levels [151 ± 70 mg/dL (6.1 ± 1.8 mmol/L); P = 0.746] were similar, whereas LDL-C_Lp(a)corM/H levels were significantly lower than LDL-C_F [121 ± 62 mg/dL (3.1 ± 1.6 mmol/L); P < 0.001]. Target achievement as per latest guidelines in treated patients using the LDL-C_M/H (2.5%) and especially LDL-C_Lp(a)corM/H methods (10.7%) were significantly different than LDL-C_F (2.9%; P < 0.001). In children, all 3 formulas resulted in similar LDL-C levels, both at diagnosis and in treated patients. However, target achievement by LDL-C_F was lower compared with LDL-C_M/H and LDL-C_Lp(a)corM/H methods (22.1 vs 24.8 vs 33.3%; P < 0.001 for both comparisons). Conclusion: LDL-C_Lp(a)corM/H results in significantly lower values and higher target achievement rate in both treated adults and children. If validated in clinical trials, LDL-C_Lp(a)corM/H may become the method of choice to more accurately estimate 'true' LDL-C levels in FH patients.

Original language	English
Article number	114
Pages (from-to)	1-13
Number of pages	13
Journal	Lipids in Health and Disease
Volume	19
Issue number	1
DOIs	https://doi.org/10.1186/s12944-020-01289-5
Publication status	Published - 28 May 2020
Externally published	Yes

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Rizos, C. V., Florentin, M., Skoumas, I., Tziomalos, K., Rallidis, L., Kotsis, V., Athyros, V., Skalidis, E., Kolovou, G., Garoufi, A., Bilianou, E., Koutagiar, I., Agapakis, D., Kiouri, E., Antza, C., Katsiki, N., Zacharis, E., Attilakos, A., Sfikas, G., ... Liberopoulos, E. N. (2020). Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry. Lipids in Health and Disease, 19(1), 1-13. Article 114. https://doi.org/10.1186/s12944-020-01289-5

@article{1587bc50abbf441f92c8c173a393b77b,

title = "Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry",

abstract = "Background: Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed. Methods: Patients with FH were recruited by a network of Greek sites participating in the HELLAS-FH registry. LDL-C levels were calculated using the Friedewald (LDL-CF) and the Martin/Hopkins (LDL-CM/H) equations as well as after correcting LDL-CM/H for Lp(a) levels [LDL-CLp(a)corM/H]. The objective was to compare LDL-C levels and target achievement as estimated by different methods in FH patients. Results: This analysis included 1620 patients (1423 adults and 197 children). In adults at diagnosis, LDL-CF and LDL-CM/H levels were similar [235 ± 70 mg/dL (6.1 ± 1.8 mmol/L) vs 235 ± 69 mg/dL (6.1 ± 1.8 mmol/L), respectively; P = NS], while LDL-CLp(a)corM/H levels were non-significantly lower than LDL-CF [211 ± 61 mg/dL (5.5 ± 1.6 mmol/L); P = 0.432]. In treated adults (n = 966) both LDL-CF [150 ± 71 mg/dL (3.9 ± 1.8 mmol/L)] and LDL-CM/H levels [151 ± 70 mg/dL (6.1 ± 1.8 mmol/L); P = 0.746] were similar, whereas LDL-CLp(a)corM/H levels were significantly lower than LDL-CF [121 ± 62 mg/dL (3.1 ± 1.6 mmol/L); P < 0.001]. Target achievement as per latest guidelines in treated patients using the LDL-CM/H (2.5\%) and especially LDL-CLp(a)corM/H methods (10.7\%) were significantly different than LDL-CF (2.9\%; P < 0.001). In children, all 3 formulas resulted in similar LDL-C levels, both at diagnosis and in treated patients. However, target achievement by LDL-CF was lower compared with LDL-CM/H and LDL-CLp(a)corM/H methods (22.1 vs 24.8 vs 33.3\%; P < 0.001 for both comparisons). Conclusion: LDL-CLp(a)corM/H results in significantly lower values and higher target achievement rate in both treated adults and children. If validated in clinical trials, LDL-CLp(a)corM/H may become the method of choice to more accurately estimate 'true' LDL-C levels in FH patients.",

keywords = "Cardiovascular disease, Familial hypercholesterolemia, Friedewald, Greece, Hellenic familial hypercholesterolemia registry, Hypolipidemic treatment, Lipoprotein (a), Martin/Hopkins, Target achievement",

author = "Rizos, \{Christos V.\} and Matilda Florentin and Ioannis Skoumas and Konstantinos Tziomalos and Loukianos Rallidis and Vasileios Kotsis and Vasileios Athyros and Emmanouil Skalidis and Genovefa Kolovou and Anastasia Garoufi and Eleni Bilianou and Iosif Koutagiar and Dimitrios Agapakis and Estela Kiouri and Christina Antza and Niki Katsiki and Evangelos Zacharis and Achilleas Attilakos and George Sfikas and Panagiotis Anagnostis and Panagiotakos, \{Demosthenes B.\} and Liberopoulos, \{Evangelos N.\}",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s).",

year = "2020",

month = may,

day = "28",

doi = "10.1186/s12944-020-01289-5",

language = "English",

volume = "19",

pages = "1--13",

journal = "Lipids in Health and Disease",

issn = "1476-511X",

publisher = "BioMed Central",

number = "1",

}

Rizos, CV, Florentin, M, Skoumas, I, Tziomalos, K, Rallidis, L, Kotsis, V, Athyros, V, Skalidis, E, Kolovou, G, Garoufi, A, Bilianou, E, Koutagiar, I, Agapakis, D, Kiouri, E, Antza, C, Katsiki, N, Zacharis, E, Attilakos, A, Sfikas, G, Anagnostis, P, Panagiotakos, DB & Liberopoulos, EN 2020, 'Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry', Lipids in Health and Disease, vol. 19, no. 1, 114, pp. 1-13. https://doi.org/10.1186/s12944-020-01289-5

Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry. / Rizos, Christos V.; Florentin, Matilda; Skoumas, Ioannis et al.
In: Lipids in Health and Disease, Vol. 19, No. 1, 114, 28.05.2020, p. 1-13.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia

T2 - An analysis from the HELLAS-FH registry

AU - Rizos, Christos V.

AU - Florentin, Matilda

AU - Skoumas, Ioannis

AU - Tziomalos, Konstantinos

AU - Rallidis, Loukianos

AU - Kotsis, Vasileios

AU - Athyros, Vasileios

AU - Skalidis, Emmanouil

AU - Kolovou, Genovefa

AU - Garoufi, Anastasia

AU - Bilianou, Eleni

AU - Koutagiar, Iosif

AU - Agapakis, Dimitrios

AU - Kiouri, Estela

AU - Antza, Christina

AU - Katsiki, Niki

AU - Zacharis, Evangelos

AU - Attilakos, Achilleas

AU - Sfikas, George

AU - Anagnostis, Panagiotis

AU - Panagiotakos, Demosthenes B.

AU - Liberopoulos, Evangelos N.

PY - 2020/5/28

Y1 - 2020/5/28

N2 - Background: Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed. Methods: Patients with FH were recruited by a network of Greek sites participating in the HELLAS-FH registry. LDL-C levels were calculated using the Friedewald (LDL-CF) and the Martin/Hopkins (LDL-CM/H) equations as well as after correcting LDL-CM/H for Lp(a) levels [LDL-CLp(a)corM/H]. The objective was to compare LDL-C levels and target achievement as estimated by different methods in FH patients. Results: This analysis included 1620 patients (1423 adults and 197 children). In adults at diagnosis, LDL-CF and LDL-CM/H levels were similar [235 ± 70 mg/dL (6.1 ± 1.8 mmol/L) vs 235 ± 69 mg/dL (6.1 ± 1.8 mmol/L), respectively; P = NS], while LDL-CLp(a)corM/H levels were non-significantly lower than LDL-CF [211 ± 61 mg/dL (5.5 ± 1.6 mmol/L); P = 0.432]. In treated adults (n = 966) both LDL-CF [150 ± 71 mg/dL (3.9 ± 1.8 mmol/L)] and LDL-CM/H levels [151 ± 70 mg/dL (6.1 ± 1.8 mmol/L); P = 0.746] were similar, whereas LDL-CLp(a)corM/H levels were significantly lower than LDL-CF [121 ± 62 mg/dL (3.1 ± 1.6 mmol/L); P < 0.001]. Target achievement as per latest guidelines in treated patients using the LDL-CM/H (2.5%) and especially LDL-CLp(a)corM/H methods (10.7%) were significantly different than LDL-CF (2.9%; P < 0.001). In children, all 3 formulas resulted in similar LDL-C levels, both at diagnosis and in treated patients. However, target achievement by LDL-CF was lower compared with LDL-CM/H and LDL-CLp(a)corM/H methods (22.1 vs 24.8 vs 33.3%; P < 0.001 for both comparisons). Conclusion: LDL-CLp(a)corM/H results in significantly lower values and higher target achievement rate in both treated adults and children. If validated in clinical trials, LDL-CLp(a)corM/H may become the method of choice to more accurately estimate 'true' LDL-C levels in FH patients.

AB - Background: Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed. Methods: Patients with FH were recruited by a network of Greek sites participating in the HELLAS-FH registry. LDL-C levels were calculated using the Friedewald (LDL-CF) and the Martin/Hopkins (LDL-CM/H) equations as well as after correcting LDL-CM/H for Lp(a) levels [LDL-CLp(a)corM/H]. The objective was to compare LDL-C levels and target achievement as estimated by different methods in FH patients. Results: This analysis included 1620 patients (1423 adults and 197 children). In adults at diagnosis, LDL-CF and LDL-CM/H levels were similar [235 ± 70 mg/dL (6.1 ± 1.8 mmol/L) vs 235 ± 69 mg/dL (6.1 ± 1.8 mmol/L), respectively; P = NS], while LDL-CLp(a)corM/H levels were non-significantly lower than LDL-CF [211 ± 61 mg/dL (5.5 ± 1.6 mmol/L); P = 0.432]. In treated adults (n = 966) both LDL-CF [150 ± 71 mg/dL (3.9 ± 1.8 mmol/L)] and LDL-CM/H levels [151 ± 70 mg/dL (6.1 ± 1.8 mmol/L); P = 0.746] were similar, whereas LDL-CLp(a)corM/H levels were significantly lower than LDL-CF [121 ± 62 mg/dL (3.1 ± 1.6 mmol/L); P < 0.001]. Target achievement as per latest guidelines in treated patients using the LDL-CM/H (2.5%) and especially LDL-CLp(a)corM/H methods (10.7%) were significantly different than LDL-CF (2.9%; P < 0.001). In children, all 3 formulas resulted in similar LDL-C levels, both at diagnosis and in treated patients. However, target achievement by LDL-CF was lower compared with LDL-CM/H and LDL-CLp(a)corM/H methods (22.1 vs 24.8 vs 33.3%; P < 0.001 for both comparisons). Conclusion: LDL-CLp(a)corM/H results in significantly lower values and higher target achievement rate in both treated adults and children. If validated in clinical trials, LDL-CLp(a)corM/H may become the method of choice to more accurately estimate 'true' LDL-C levels in FH patients.

KW - Cardiovascular disease

KW - Familial hypercholesterolemia

KW - Friedewald

KW - Greece

KW - Hellenic familial hypercholesterolemia registry

KW - Hypolipidemic treatment

KW - Lipoprotein (a)

KW - Martin/Hopkins

KW - Target achievement

UR - https://www.scopus.com/pages/publications/85085636135

U2 - 10.1186/s12944-020-01289-5

DO - 10.1186/s12944-020-01289-5

M3 - Article

C2 - 32466791

AN - SCOPUS:85085636135

SN - 1476-511X

VL - 19

SP - 1

EP - 13

JO - Lipids in Health and Disease

JF - Lipids in Health and Disease

IS - 1

M1 - 114

ER -

Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: An analysis from the HELLAS-FH registry

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