In:
Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. Suppl_1 ( 2018-05)
Abstract:
Background and Aims: Familial hypercholesterolemia (FH) is a high risk of developing premature coronary artery disease even in heterozygotes. It is reported that the diagnostic rate in Japan and the United States is extremely low compared with the Netherlands and a few countries. The diagnostic criteria of FH vary from country to country. Using the JASb(Japan Atherosclerosis Society) diagnostic criteria, it has been shown that sensitivity and specificity in patients who visited lipid clinics are high, but those in the general population are not clear. In this study, we tried to screen FH in a clinic of a large Japanese corporation. Methods: During the period from July 1, 2014 to October 31, 2017, we extracted patients suspected of FH with LDL-C≧180mg/dL or with a family history of CAD at annual and follow-up medical checkup. In the extracted patients, family history of premature CAD and Achilles tendon thickening were evaluated. For patients to which additional information was added, FH diagnosis by JAS diagnostic criteria and by Dutch criteria were performed. Results: A total of 3,3136 medical checkups were set for about 6,300 subjects, and a total of 2,8108 visits were made (the examination rate was 84.8%). Among them, 328 patients with suspected FH were extracted due to LDL-C of 180 mg/dL or more, or family history of CAD. Among subjects additional information was obtained as of November 2017, 43 (19.6%) were diagnosed as FH on JAS criteria, and the number was higher than predicted from the estimated prevalence of FH. On the other hand, there were 24 patients who were "Definite" or "Probably" in Dutch criteria and 211 patients with LDL-C≧190 mg/dL. LDL-C of patients diagnosed as FH by JAS diagnostic criteria was 206.6 (45.3) mg/dL, while patients who did not meet the criteria also had high LDL-C values as 201.4 (18.6) mg/dL. 26.8% of patients who met the diagnostic criteria of FH had not received statin at the time of evaluation. Conclusion: The number of patients satisfying the JAS criteria was more than predicted from the prevalence, suggesting the possibility of over-diagnosis. On the other hand, there were many patients who do not satisfy the diagnostic criteria even when LDL-C is very high.
Type of Medium:
Online Resource
ISSN:
1079-5642
,
1524-4636
DOI:
10.1161/atvb.38.suppl_1.243
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
1494427-3
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