The German CaRe high registry for familial hypercholesterolemia: Sex differences, treatment strategies, and target value attainment
Background and aims - Familial hypercholesterolemia (FH) is among the most common genetic disorders in primary care. However, only 15% or less of patients are diagnosed, and few achieve the goals for low-density lipoprotein cholesterol (LDL-C). In this analysis of the German Cascade Screening and Re...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
September 2023
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| In: |
Atherosclerosis plus
Year: 2023, Volume: 53, Pages: 6-15 |
| ISSN: | 2667-0895 |
| DOI: | 10.1016/j.athplu.2023.06.001 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.athplu.2023.06.001 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2667089523000093 |
| Author Notes: | Winfried März, Nina Schmidt, Ira an Haack, Alexander Dressel, Tanja B. Grammer, Marcus E. Kleber, Andrea Baessler, F. Ulrich Beil, Ioanna Gouni-Berthold, Ulrich Julius, Ursula Kassner, Julius L. Katzmann, Gerald Klose, Christel König, Wolfgang Koenig, Ann-Cathrin Koschker, Ulrich Laufs, Martin Merkel, Britta Otte, Klaus G. Parhofer, Wibke Hengstenberg, Heribert Schunkert, Ksenija Stach-Jablonski, Elisabeth Steinhagen-Thiessen, Christoph B. Olivier, Harry Hahmann, Stefan Krzossok, Anja Vogt, Dirk Müller-Wieland, Ulrike Schatz |
| Summary: | Background and aims - Familial hypercholesterolemia (FH) is among the most common genetic disorders in primary care. However, only 15% or less of patients are diagnosed, and few achieve the goals for low-density lipoprotein cholesterol (LDL-C). In this analysis of the German Cascade Screening and Registry for High Cholesterol (CaRe High), we examined the status of lipid management, treatment strategies, and LDL-C goal attainment according to the ESC/EAS dyslipidemia guidelines. - Methods - We evaluated consolidated datasets from 1501 FH patients diagnosed clinically and seen either by lipid specialists or general practitioners and internists. We conducted a questionnaire survey of both the recruiting physicians and patients. - Results - Among the 1501 patients, 86% regularly received lipid-lowering drugs. LDL-C goals were achieved by 26% and 10% of patients with atherosclerotic cardiovascular disease (ASCVD) according to the 2016 and 2019 ESC/EAS dyslipidemia guidelines, respectively. High intensity lipid-lowering was administered more often in men than in women, in patients with ASCVD, at higher LDL-C and in patients with a genetic diagnosis of FH. - Conclusions - FH is under-treated in Germany compared to guideline recommendations. Male gender, genetic proof of FH, treatment by a specialist, and presence of ASCVD appear to be associated with increased treatment intensity. Achieving the LDL-C goals of the 2019 ESC/EAS dyslipidemia guidelines remains challenging if pre-treatment LDL-C is very high. |
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| Item Description: | Online verfügbar: 12. Juni 2023, Artikelversion: 21. Juni 2023 Gesehen am 08.08.2024 |
| Physical Description: | Online Resource |
| ISSN: | 2667-0895 |
| DOI: | 10.1016/j.athplu.2023.06.001 |