Familial hypercholesterolemia and vulnerability of coronary plaque in patients with coronary artery disease.

ABSTRACT:

Objectives

Patients with familial hypercholesterolemia (FH) are at a very high risk of coronary artery diseases. The aim of the present study was to clarify the characteristics of coronary plaque in patients with FH.

Design

and Methods: A total of 569 patients who underwent optical coherence tomography (OCT) imaging of culprit plaque were included. The characteristics of culprit plaque were compared between patients with and without FH.

Results

A total of 38 patients (6.7%) were clinically diagnosed with FH. The location of the culprit plaque was significantly different (p ?< ?0.001) with a trend toward higher frequency of left main lesion in the FH group than in the group with no FH (7.9 vs. 0%). Culprit plaque was significantly shorter in patients with FH than those without FH (28.1 vs. 33.2 ?mm, p ?= ?0.016). A trend toward higher prevalence of plaque with macrophage accumulation in patients with FH than those without FH (50.0 vs. 34.7%, p ?= ?0.056) was observed, although the prevalence of other vulnerable characteristics including thin-cap fibroatheroma (TCFA) was comparable between patients with and without FH. Among patients with FH, significant increases in the prevalence of lipid-rich plaque (p ?= ?0.028) and TCFA (p ?= ?0.003) were observed according to the increase in low-density lipoprotein cholesterol (LDL-C) levels.

Conclusions

Patients with FH had shorter culprit plaque without significant difference in the prevalence of vulnerable plaque components compared with patients without FH. A higher LDL-C level was associated with higher prevalence of vulnerable plaque in patients with FH.

SUBMITTER: Katamine M 

PROVIDER: S-EPMC7895842 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature