Society Position Statement Canadian Cardiovascular Society Position Statement on Familial Hypercholesterolemia: Update 2018

被引:96
作者
Brunham, Liam R. [1 ,2 ]
Ruel, Isabelle [3 ]
Aljenedil, Sumayah [3 ]
Riviere, Jean-Baptiste [3 ]
Baass, Alexis [4 ,5 ]
Tu, Jack V. [6 ]
Mancini, G. B. John [1 ]
Raggi, Paolo [7 ]
Gupta, Milan [8 ,9 ]
Couture, Patrick [10 ,11 ]
Pearson, Glen J. [7 ]
Bergeron, Jean [10 ,11 ]
Francis, Gordon A. [1 ,12 ]
McCrindle, Brian W. [13 ]
Morrison, Katherine [14 ]
St-Pierre, Julie [15 ]
Henderson, Melanie [16 ]
Hegele, Robert A. [17 ,18 ,19 ]
Genest, Jacques [3 ,4 ]
Goguen, Jeannette [20 ,21 ]
Gaudet, Daniel [22 ,23 ]
Pare, Guillaume [24 ,25 ]
Romney, Jacques [26 ]
Ransom, Thomas [27 ]
Bernard, Sophie [5 ,28 ]
Katz, Pamela [29 ]
Joy, Tisha R. [30 ]
Bewick, David [31 ]
Brophy, James [3 ,4 ]
机构
[1] Univ British Columbia, Dept Med, Vancouver, BC, Canada
[2] Univ British Columbia, Ctr Heart Lung Innovat, Rm 166-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada
[3] McGill Univ, Hlth Ctr, Royal Victoria Hosp, Res Inst, Montreal, PQ, Canada
[4] McGill Univ, Dept Med, Montreal, PQ, Canada
[5] Inst Rech Clin Montreal, Nutr Metab & Atherosclerosis Clin, Montreal, PQ, Canada
[6] Univ Toronto, Inst Clin Evaluat Sci, Schulich Heart Ctr, Sunnybrook Hlth Sci Ctr,Fac Med, Toronto, ON, Canada
[7] Univ Alberta, Mazankowski Alberta Heart Inst, Edmonton, AB, Canada
[8] McMaster Univ, Dept Med, Hamilton, ON, Canada
[9] Canadian Collaborat Res Network, Brampton, ON, Canada
[10] Quebec Univ Laval, CHU, Dept Med, Quebec City, PQ, Canada
[11] Quebec Univ Laval, CHU, Dept Lab Med, Quebec City, PQ, Canada
[12] Univ British Columbia, Ctr Heart Lung Innovat, Vancouver, BC, Canada
[13] Univ Toronto, Hosp Sick Children, Labatt Family Heart Ctr, Dept Pediat, Toronto, ON, Canada
[14] McMaster Univ, Dept Pediat, Hamilton, ON, Canada
[15] McGill Univ, Dept Pediat, Clin 180, Montreal, PQ, Canada
[16] Univ Montreal, CHU St Etienne, Dept Pediat, Montreal, PQ, Canada
[17] Western Univ, Dept Med, Schulich Sch Med, London, ON, Canada
[18] Western Univ, Dept Biochem, Schulich Sch Med, London, ON, Canada
[19] Western Univ, Robarts Res Inst, London, ON, Canada
[20] Univ Toronto, Dept Med, Toronto, ON, Canada
[21] St Michaels Hosp, Div Endocrinol, Toronto, ON, Canada
[22] Univ Montreal, Lipidol Unit, Community Genom Med Ctr, Saguenay, PQ, Canada
[23] Univ Montreal, ECOGENE 21, Dept Med, Saguenay, PQ, Canada
[24] McMaster Univ, Hamilton Hlth Sci, Dept Pathol & Mol Med, Dept Clin Epidemiol & Biostat,Populat Hlth Res In, Hamilton, ON, Canada
[25] McMaster Univ, Hamilton Hlth Sci, Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada
[26] Univ Alberta, Dept Med, Div Endocrinol & Metab, Edmonton, AB, Canada
[27] Dalhousie Univ, Queen Elizabeth II Hlth Sci Ctr, Halifax, NS, Canada
[28] Univ Montreal, Div Endocrinol, Dept Med, Montreal, PQ, Canada
[29] Univ Manitoba, St Boniface Hosp, Sect Endocrinol & Metab, Dept Med, Winnipeg, MB, Canada
[30] Western Univ, Schulich Sch Med & Dent, London, ON, Canada
[31] Dalhousie Univ, Div Cardiol, Dept Med, St John, NB, Canada
关键词
CORONARY-ARTERY-DISEASE; CHOLESTEROL CONCENTRATION; GENERAL-POPULATION; PREVALENCE; STATINS; ADOLESCENTS; ALIROCUMAB; REFINEMENT; ATTAINMENT; MANAGEMENT;
D O I
10.1016/j.cjca.2018.09.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Familial hypercholesterolemia (FH) is the most common monogenic disorder causing premature atherosclerotic cardiovascular disease. It affects 1 in 250 individuals worldwide, and of the approximately 145,000 Canadians estimated to have FH, most are undiagnosed. Herein, we provide an update of the 2014 Canadian Cardiovascular Society position statement on FH addressing the need for case identification, prompt recognition, and treatment with statins and ezetimibe, and cascade family screening. We provide a new Canadian definition for FH and tools for clinicians to make a diagnosis. The risk of atherosclerotic cardiovascular disease in patients with "definite" FH is 10- to 20-fold that of a normolipidemic individual and initiating treatment in youth or young adulthood can normalize life expectancy. Target levels for low-density lipoprotein cholesterol are proposed and are aligned with the Canadian Cardiovascular Society guidelines on dyslipidemia. Recommendation for the use of inhibitors of proprotein convertase kexin/subtilisin type 9 are made in patients who cannot achieve therapeutic low-density lipoprotein cholesterol targets on maximally tolerated statins and ezetimibe. The writing committee used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology in the preparation of the present document, which offers guidance for practical evaluation and management of patients with FH. This position statement also aims to raise awareness of FH nationally, and to mobilize patient support, promote knowledge translation, and availability of treatment and health care resources for this under-recognized, but important medical condition.
引用
收藏
页码:1553 / 1563
页数:11
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