Abstract
A 61-year-old woman with a history of severe, uncontrolled arterial hypertension, coronary artery disease, heterozygous familial hypercholesterolemia (FH), metabolic syndrome and numerous comorbidities, after many percutaneous coronary interventions (PCI) and vascular interventions was admitted to the hospital due to exacerbation of angina. Coronary angiography revealed hemodynamically significant stenosis in the circumflex branch and artery angioplasty with drug eluting stent (DES) was successfully performed. Laboratory tests revealed still significantly elevated levels of LDL cholesterol. The patient was previously treated with LDL apheresis which has been interrupted due to a history of ischemic strokes complicated by hemiparesis and aphasia. Pharmacological treatment has been modified, control visit and resuming LDL-apheresis or PCSK-9 therapy consideration prescribed. After obtaining the improvement of compliance good control of blood pressure was confirmed. The presented case provide the possibility of using different therapeutic strategies in patients with familial hypercholesterolemia and underlines the key role of compliance in the control of risk factors for cardiovascular diseases, particularly hypertension.
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