Asociación de la presencia de placa carotídea en la aparición de eventos cardiovasculares en pacientes con hipercolesterolemias genéticas [Association Between the Presence of Carotid Artery Plaque and Cardiovascular Events in Patients With Genetic Hypercholesterolemia]

Bea, Ana M. ; Civeira, Fernando (Universidad de Zaragoza) ; Jarauta, Estíbaliz (Universidad de Zaragoza) ; Lamiquiz-Moneo, Itziar. ; Pérez-Calahorra, Sofía ; Marco-Benedí, Victoria ; Cenarro, Ana ; Mateo-Gallego, Rocío (Universidad de Zaragoza)

Resumen: Introduction and objectives The equations used in the general population to calculate cardiovascular risk are not useful in genetic hypercholesterolemia (GH). Carotid plaque detection has proved useful in cardiovascular prediction and risk reclassification but there have been no studies of its usefulness in GH. The aim of this study was to determine the association between the presence of carotid artery plaque and the occurrence of cardiovascular events in patients with GH. Methods This study included 1778 persons with GH. The mean follow-up until the occurrence of cardiovascular events was 6.26 years. At presentation, the presence of carotid artery plaque was studied by high-resolution ultrasound. Results Carotid artery plaque was found in 661 (37.2%) patients: 31.9% with familial hypercholesterolemia, 39.8% with familial combined hyperlipidemia, 45.5% with dysbetalipoproteinemia, and 43.2% with polygenic hypercholesterolemia. During follow-up, 58 patients had a cardiovascular event. Event rates were 6354/100 000 (95%CI, 4432.4-8275.6) in the group with plaque and 1432/100 000 (95%CI, 730.6-2134.3) in the group without plaque, with significant differences between the 2 groups (P <.001). The relative risk of an event was 4.34 (95CI%, 2.44-7.71; P <.001) times higher in patients with plaque and was 2.40 (95%CI, 1.27-4.56; P =.007) times higher after adjustment for major risk factors. The number of carotid artery plaques was positively associated with the risk of cardiovascular events. Conclusions Most cardiovascular events occur in a subgroup of patients who can be identified by carotid plaque detection. These results support the use of plaque screening in this population and should help in risk stratification and treatment in GH. Full English text available from: www.revespcardiol.org/en

Idioma: Español

DOI: 10.1016/j.recesp.2016.10.018

Año: 2017

Publicado en: Revista Española de Cardiología 70, 7 (2017), 551-558
ISSN: 0300-8932

Factor impacto JCR: 5.166 (2017)

Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 26 / 128 = 0.203 (2017) - Q1 - T1

Factor impacto SCIMAGO: 0.553 - Cardiology and Cardiovascular Medicine (Q2)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/RD12-0042-0055
Financiación: info:eu-repo/grantAgreement/ES/MINECO/PI12-01087
Financiación: info:eu-repo/grantAgreement/ES/MINECO/PI12-01321
Financiación: info:eu-repo/grantAgreement/ES/MINECO/PI12-01703

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)