P820The prevalence and management of familial hypercholesterolemia in patients with acute coronary syndrome in Poland: results of the TERCET Registry

Abstract

Abstract Background Prevalence of familial hypercholesterolemia (FH) is high among patients with CAD. However, data on FH among ACS patients are still scarce. Therefore, we aimed to assess the prevalence, lipid-lowering therapy and short- and long-term outcomes in FH patients with ACS. Methods We finally included 19,781 consecutive patients from the Hyperlipidaemia Therapy in the tERtiary Cardiological cEnTer (TERCET) Registry for years 2006–2018, including 7,319 patients with ACS: 3,085 with STEMI, 2,256 with NSTEMI, and 1,978 due to unstable angina (UA) (stable CAD group [n=12,462] was treated as a reference). FH diagnosis was based on Dutch Lipid Clinic Network (DLCN) score. Results The overall occurrence of probable/definite FH and possible FH were 1.2% and 13.7% respectively. In ACS patients 1.6% had probable/definite FH and 17.0% possible FH. The highest occurrence of FH was observed in STEMI subgroup, where 20.6% of the patients had ≥3 points according to the DLCN criteria. In patients with definite/probable FH, 98.1% were administered statins at discharge (including 57.5% prescribed intensive statin therapy in comparison to only 23.7% in non-FH patients). Patients with definite/probable FH had higher in-hospital and 30-day mortality than patients without FH (3.5% vs 1.2%, p=0.0046 and 4.4% vs 1.7%, p=0.024, respectively). However, no significant differences in investigated outcomes were observed between the FH groups in the 12-month and 36-month follow-up. The number of patients with FH Conclusion The prevalence of FH (definite/probable/possible) in the Polish very high-risk population is even 14.9% and is significantly higher in patients with ACS than in patients with stable CAD. High intensive lipid lowering therapy, including the combination therapy allows improving long-term outcomes in patients with FH.