Statins in childhood aid familial hypercholesteremia outcomes

(HealthDay)—Initiation of statin therapy during childhood in patients with familial hypercholesterolemia slows the progression of carotid intima-media thickness and reduces the risk for cardiovascular disease over 20 years, according to a study published in the Oct. 17 issue of the New England Journal of Medicine.

Ilse K. Luirink, M.D., from the Amsterdam University Medical Centers, and colleagues report findings of a 20-year follow-up study of statin therapy among 184 patients with familial hypercholesterolemia who enrolled in a clinical trial as children. The incidence of cardiovascular disease among the patients with familial hypercholesterolemia and 77 unaffected siblings was compared to that among their 156 affected parents.

The researchers found that the mean low-density lipoprotein (LDL) cholesterol level in the patients decreased from 237.3 to 160.7 mg/dL from the baseline level, with 20 percent of patients achieving treatment goals (LDL cholesterol <100 mg/dL). During follow-up, the mean progression of carotid intima-media thickness was 0.0056 mm per year in patients with familial hypercholesterolemia and 0.0057 mm per year in siblings (mean difference adjusted for sex, −0.0001 mm per year; 95 percent confidence interval, −0.0010 to 0.0008). At 39 years of age, the cumulative incidence of cardiovascular events and death from cardiovascular causes was lower among the patients with familial hypercholesterolemia compared with their affected parents (1 versus 26 percent and 0 versus 7 percent, respectively).

"Despite the modest percentage of patients with familial hypercholesterolemia in whom treatment goals were achieved, our findings suggest a positive effect on both the studied surrogate marker (carotid intima-media thickness) and on hard cardiovascular disease outcomes," the authors write.

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