000168743 001__ 168743
000168743 005__ 20260217214838.0
000168743 0247_ $$2doi$$a10.1016/j.rec.2025.07.004
000168743 0248_ $$2sideral$$a148131
000168743 037__ $$aART-2025-148131
000168743 041__ $$aeng
000168743 100__ $$0(orcid)0000-0001-7043-0952$$aCiveira, Fernando$$uUniversidad de Zaragoza
000168743 245__ $$aClassification, prevalence and cardiovascular risk of different types of hypercholesterolemia
000168743 260__ $$c2025
000168743 5203_ $$aIntroduction and objectives: The frequency, clinical characteristics and risk of atherosclerotic cardiovascular disease (ASCVD) of the different types of hypercholesterolemia are not well established. The primary and secondary objectives of this study were to determine the cause of hypercholesterolemia and whether the cause confers a different ASCVD prognosis.
Methods: The analysis included 3474 probands with primary hypercholesterolemia, of whom 3283 (94.8%) were followed up for 9.33 ± 5.8 years for ASCVD. Genetic analysis of familial hypercholesterolemia (FH) genes, polygenic risk score for ypercholesterolemia, and lipid concentrations, including lipoprotein(a), were used to classify hypercholesterolemia.
Results: The diagnoses were heterozygous FH, n = 400 (11.5%); hyperlipoproteinemia(a), n = 181 (5.2%); polygenic hypercholesterolemia, n = 434 (12.5%); hyperlipoproteinemia(a) plus polygenic hypercholesterolemia, n = 128 (3.7%); multifactorial, n = 1562 (45.0%); and idiopathic, n = 769 (22.1%). At baseline, low-density lipoprotein cholesterol levels were higher in heterozygous FH, and the prevalence of ASCVD was higher in hyperlipoproteinemia(a). Other clinical and biochemical characteristics did not differ among hypercholesterolemia subgroups. The survival rate was lower in participants with hyperlipoproteinemia(a) than in the other hypercholesterolemia groups (P = .001). Variables independently associated with ASCVD events during follow-up were age, male sex, the presence of ASCVD, diabetes or hypertension at baseline, current smoking, lipoprotein(a) concentration, and high-density lipoprotein cholesterol concentration, the latter being inversely associated with ASCVD events. Total mortality was independent of the type of hypercholesterolemia.
Conclusions: Genetic hypercholesterolemia has a worse prognosis for ASCVD than nongenetic hypercholesterolemia. Among individuals with genetic hypercholesterolemia, those with elevated lipoprotein(a) have the worst prognosis. Conventional lipidowering treatment for low-density lipoprotein cholesterol appears to be less effective in hypercholesterolemia due to hyperlipoproteinemia (a) than in other forms of hypercholesterolemia.
000168743 536__ $$9info:eu-repo/grantAgreement/ES/DGA/B14$$9info:eu-repo/grantAgreement/ES/ISCIII-MINECO/PI19-00694$$9info:eu-repo/grantAgreement/ES/ISCIII-MINECO/PI22-01595
000168743 540__ $$9info:eu-repo/semantics/closedAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000168743 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000168743 700__ $$0(orcid)0000-0001-9142-0737$$aJarauta, Estíbaliz$$uUniversidad de Zaragoza
000168743 700__ $$aMarco-Benedí, Victoria$$uUniversidad de Zaragoza
000168743 700__ $$aBea, Ana M.
000168743 700__ $$0(orcid)0000-0001-6650-8294$$aMateo-Gallego, Rocío$$uUniversidad de Zaragoza
000168743 700__ $$0(orcid)0000-0002-9647-0108$$aLamiquiz-Moneo, Itziar$$uUniversidad de Zaragoza
000168743 700__ $$0(orcid)0000-0003-1028-8581$$aGracia-Rubio, Irene$$uUniversidad de Zaragoza
000168743 700__ $$aBello-Álvarez, Daniel
000168743 700__ $$0(orcid)0000-0003-3963-0846$$aLaclaustra, Martín$$uUniversidad de Zaragoza
000168743 700__ $$0(orcid)0000-0001-5026-5144$$aTejedor, María Teresa$$uUniversidad de Zaragoza
000168743 700__ $$0(orcid)0000-0002-1869-7227$$aOlmos, Salvador$$uUniversidad de Zaragoza
000168743 700__ $$aCenarro, Ana
000168743 7102_ $$11006$$2255$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Enfermería
000168743 7102_ $$11001$$2420$$aUniversidad de Zaragoza$$bDpto. Anatom.,Embri.Genét.Ani.$$cÁrea Genética
000168743 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000168743 7102_ $$11003$$2027$$aUniversidad de Zaragoza$$bDpto. Anatom.Histolog.Humanas$$cArea Anatom.Embriol.Humana
000168743 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000168743 773__ $$g79, 2 (2025), 131-141$$tRevista Española de Cardiología (English Edition)$$x1885-5857
000168743 8564_ $$s1718305$$uhttps://zaguan.unizar.es/record/168743/files/texto_completo.pdf$$yVersión publicada$$zinfo:eu-repo/date/embargoEnd/2026-08-07
000168743 8564_ $$s2386495$$uhttps://zaguan.unizar.es/record/168743/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada$$zinfo:eu-repo/date/embargoEnd/2026-08-07
000168743 909CO $$ooai:zaguan.unizar.es:168743$$particulos$$pdriver
000168743 951__ $$a2026-02-17-20:14:44
000168743 980__ $$aARTICLE