A cute coronary syndrome in young patients with familial hyperchooles terolemia based on the results of oracul II observation trial

Abstract

Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder with an estimated prevalence of 1/200-1/500 in the general population. In order to diagnose this disorder it is very important to examine thoroughly patients who developed early acute coronary syndrome (ACS). The aim of this study was to assess the specific features of ACS in young patients with and without FH. Of 1754 ACS patients from multicenter observational trial ORACUL-II 322 patients with early onset of ACS (≤55 years of age for men and ≤60 years of age for women) were selected. Dutch Lipid Clinic Network (I) and Simone Broome Register (II) criteria were used to diagnose FH. NSTEMI was observed in 153 patients (47.5 %) and STEMI in 169 (52.5 %). All 6 patients with definite/ possible FH (I) developed STEMI, while in patients with probable FH or without FH only 156 (51.6 %) had STEMI (p=0.03). Among patients with probable FH (II) 16 (76.2 %) developed STEMI and without FH - 153 (50.8 %) (p=0.04). These data indicate the importance of early diagnosis and prevention of FH since these patients more often and much earlier develop STEMI, which might contribute to worse prognosis.