493 Frequency of Familial Hypercholesterolaemia and Elevated Lipoprotein(a) in Premature Coronary Artery Disease

Abstract

Familial hypercholesterolaemia (FH) and raised lipoprotein(a) (Lp(a)) are important risk factors for premature (age <60 years) coronary artery disease (CAD). However, their awareness remains low in hospital settings. Selective screening of patients admitted with premature CAD is important as it can alter the management plan post discharge. We aim to describe the frequency of FH and raised Lp(a) amongst patients admitted with premature CAD. Using the Dutch Lipid Clinic Network Score (DLCNS), we collected data [including testing for Lp(a)] from patients admitted with acute coronary syndrome over a two-month period at a tertiary hospital in Western Australia. A total of 114 patients were admitted with premature CAD during this period with male preponderance (70.2% males vs 29.8% females, p<0.05). The point prevalence of probable/definite FH was 18.4% and 43.9% with “possible FH”. Of the 18.4% with probable/definite FH, two-thirds had an untreated LDL-C of ≥4 mmol/L and 42.9% with LDL-C ≥5mmol/L. Amongst those with LDL-C of 3.9 mmol/L or less, 37.2% had raised Lp(a) of 0.3 g/L or more and amongst them, 21.1% had Lp(a) of 0.5 g/L or more. FH and raised Lp(a) remain prevalent amongst patients with premature CAD. Selective screening in these patients provides clinicians the opportunity to devise specific management plan including initiating cascade screening in patients with FH.