Suboptimal consideration and management of potential familial hypercholesterolaemia in patients with suspected premature coronary artery disease

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Title Suboptimal consideration and management of potential familial hypercholesterolaemia in patients with suspected premature coronary artery disease
Author Yudi, M; Omera, L; McCubbery, N; Dick, S; Jayasinghe, Satyajit Rohan; Hamilton-Craig, Ian
Journal Name Singapore Medical Journal
Year Published 2012
Place of publication Singapore
Publisher Singapore Medical Association
Abstract Introduction Familial hypercholesterolaemia (FH) is caused by an autosomal dominant mutation of the low density lipoprotein (LDL) receptor gene, resulting in high levels of LDL cholesterol and premature coronary artery disease (P-CAD). Studies have shown low detection rates of FH in patients admitted with P-CAD and suboptimal therapy at discharge. Methods Males aged ≤ 55 years and females aged ≤ 60 years who were admitted with P-CAD to the Gold Coast Hospital during a 12-month period were included in the study. The demographics, cardiovascular risk factors, examination findings, admission and discharge cardiac medications and provisional diagnoses were recorded. Diagnosis of FH was made according to internationally accepted criteria. Resu lts 210 patients were included in the study; 60% were male and 40% female (mean age 48 and 50 years, respectively). Only 96 (46%) patients' fasting lipid levels were documented (LDL-C 2.75 ± 1.0 mmol/L), and FH was considered in three (1%) cases. According to the Dutch Lipid Network criteria, three (1%) patients had probable FH, 50 (24%) had possible FH and 60 (29%) had unlikely FH. Of the 53 patients with probable or possible FH, 12 (23%) were discharged without statin therapy and 13 (25%) on the maximum recommended statin dose. Conclusion Our study has found inadequate documentation and screening for FH and suboptimal therapy in patients admitted with P-CAD. We propose a simple screening tool that can be applied to all patients admitted with suspected P-CAD in order to improve the detection rate of FH and its management.
Peer Reviewed Yes
Published Yes
Publisher URI http://www.sma.org.sg/Publications/articles.aspx?ID=BF2D7B8D-5178-4DC7-AFB7-2D83161FB991
Volume 53
Issue Number 3
Page from 174
Page to 178
ISSN 0037-5675
Date Accessioned 2012-10-15
Language en_US
Faculty Griffith Health Faculty
Subject Medical and Health Sciences
URI http://hdl.handle.net/10072/47776
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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