Misperceptions and management of LDL-cholesterol in secondary prevention of patients with familial hypercholesterolemia in cardiology practice: Real-life evidence from the EPHESUS registry

dc.contributor.authorKayıkçıoğlu, Meral
dc.contributor.authorBaşaran, Özcan
dc.contributor.authorDoğan, Volkan
dc.contributor.authorMert, Kadir Uğur
dc.contributor.authorMert, Gurbet Özge
dc.contributor.authorÖzdemir, İbrahim Halil
dc.contributor.authorRencüzoğulları, İbrahim
dc.contributor.authorİnci, Sinan
dc.date.accessioned2024-04-24T08:08:18Z
dc.date.available2024-04-24T08:08:18Z
dc.date.issued2023
dc.departmentTıp Fakültesi
dc.description.abstractFamilial hypercholesterolemia (FH) is a common inherited disease, leading to premature atherosclerotic cardiovascular disease (ASCVD) due to elevated low-density lipoprotein cholesterol (LDL-C) levels. Achieving LDL-C goals is extremely important for preventing the complications of this fatal disease. We evaluated the management of FH patients with ASCVD in cardiology practice. METHODS: We analyzed patients with ASCVD from the nationwide EPHESUS registry, which was conducted in 40 cardiology outpatient clinics, and compared those with and without FH. RESULTS: Of the 1482 consecutively enrolled patients with ASCVD, 618 (41.7%) had FH, among which 455 were categorized as 'Possible FH' and 163 as 'Probable or Definite FH'. Proposed LDL-C goals were not attained in more than 90% of the patients with FH. The proportion of those on statin therapy was 77% for possible and 91% for probable or definite FH, whereas 34.2 % and 59.4% were in use of high-intensity statins, respectively. None of the patients were on PCSK-9 inhibitors, and only 2 used ezetimibe. Adverse media coverage was the most common cause of statin discontinuation (32.5% in 'possible FH' and 45.7% in 'probable/definite FH'). The negative impact of media in the decision to stop lipid lowering therapy (LLT) was increasing with education level. CONCLUSIONS: In real life most of the FH patients with ASCVD are undertreated in cardiology practice regarding statin dosing and combined LLT. Drug discontinuation rates are notably high and are mostly media-related, and side effects very rarely cause cessation of LLT. Urgent measures are needed to increase the awareness of FH among healthcare providers and patients and to develop improved treatment strategies aimed at preventing the complications of FH.
dc.identifier.doi10.1016/j.jacl.2023.09.013
dc.identifier.endpage742en_US
dc.identifier.issn1933-2874
dc.identifier.issue6en_US
dc.identifier.pmid38072583
dc.identifier.scopusqualityQ1
dc.identifier.startpage732en_US
dc.identifier.urihttps:/dx.doi.org10.1016/j.jacl.2023.09.013
dc.identifier.urihttps://hdl.handle.net/20.500.12451/11684
dc.identifier.volume17en_US
dc.identifier.wosWOS:001165102300001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Ltd
dc.relation.ispartofJournal of Clinical Lipidology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAtherosclerotic Cardiovascular Disease
dc.subjectFamilial Hypercholesterolemia
dc.subjectLDL-cholesterol
dc.subjectLipid-lowering Therapy
dc.subjectMedia Coverage
dc.subjectSecondary Prevention
dc.titleMisperceptions and management of LDL-cholesterol in secondary prevention of patients with familial hypercholesterolemia in cardiology practice: Real-life evidence from the EPHESUS registry
dc.typeArticle

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