2022 Quality Summit ePosters (Non-CE) - CathPCI Registry-19. Prevalence, Co-Morbidities and Treatment of Clinically-Defined Severe Familial Hyperlipidemias in Patients with Early CHD in a Local ACC NCDR PCI Registry [Honorable Mention #3]

19. Prevalence, Co-Morbidities and Treatment of Clinically-Defined Severe Familial Hyperlipidemias in Patients with Early CHD in a Local ACC NCDR PCI Registry [Honorable Mention #3]

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The study aimed to determine the prevalence, co-morbidities, and outcomes of clinically defined severe familial hyperlipidemias (FH) and familial combined hyperlipidemia (FCH) in young patients who had undergone recent percutaneous coronary intervention (PCI). The researchers queried the NCDR® CathPCI Registry at two hospitals in Rhode Island to identify patients under 50 years of age who had undergone PCI between 2015-2017. The highest total cholesterol levels, follow-up labs, and family history were extracted from electronic health records. FH was defined by LDL-C ≥ 190mg/dl at age ≥ 21 years, possible, probable, or definite FH based on clinical factors plus LDL-C +/- DNA testing, or LDL-C by decade of life. FCH was presumed if TC was ≥ 240, triglycerides (TG) ≥ 225, and non-HDL-C ≥ 190mg/dl. <br /><br />Among 571 patients, the prevalence of clinical FH was 7.9% and FCH was 10.7%. Patients in the FH group had higher mean cholesterol, LDL-C, and TG levels compared to the referent group. FCH patients had higher rates of diabetes, prior myocardial infarction (MI), and admission lipid medication use compared to the referent group. More than 85% of patients underwent emergent or urgent PCI, and the burden of disease did not differ between groups. Among those with available follow-up lipids, only 18% of FH patients and 40% of FCH patients achieved an LDL level below 70mg/dl at one year. <br /><br />The study concluded that the prevalence of FH and FCH is high in young patients undergoing early PCI, yet there are large gaps in prevention. Better screening and care management are needed to improve outcomes in this high-risk patient population. The researchers suggest targeted screening for FH and FCH in young PCI patients and population health management approaches to enhance secondary prevention, family screening for primary prevention, and health and economic outcomes.

Keywords

prevalence

co-morbidities

outcomes

familial hyperlipidemias

percutaneous coronary intervention

NCDR CathPCI Registry

cholesterol levels

LDL-C

triglycerides

secondary prevention