Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Metabolic Disorder
Impact of Cardiometabolic Risk Factors on Major Cardiovascular Events in Patients With Familial Combined Hyperlipidemia
Ioannis SkoumasConstantina MasouraKonstantinos AznaouridisVassiliki MetaxaAthanassios TsokanisLambros PapadimitriouDimitrios TousoulisChristos PitsavosChristodoulos Stefanadis
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2013 Volume 77 Issue 1 Pages 163-168

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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. Methods and 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 enrolment (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.  (Circ J 2013; 77: 163–168)

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© 2013 THE JAPANESE CIRCULATION SOCIETY
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