Aortic valvular disease in elderly subjects with heterozygous familial hypercholesterolemia: impact of lipid-lowering therapy
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- dc.contributor.author Marco-Benedí, Victoria
- dc.contributor.author Laclaustra, Martín
- dc.contributor.author Casado-Dominguez, Juan M.
- dc.contributor.author Villa-Pobo, Rosa
- dc.contributor.author Mateo-Gallego, Rocío
- dc.contributor.author Sánchez-Hernández, Rosa M.
- dc.contributor.author Blanco Nuez, Marta
- dc.contributor.author Ortega-Martínez de Victoria, Emilio
- dc.contributor.author Sitges, Marta
- dc.contributor.author Pedro-Botet, Juan Carlos
- dc.contributor.author Puzo, José
- dc.contributor.author Villarroel, Teresa
- dc.contributor.author Civeira, Fernando
- dc.date.accessioned 2021-03-22T08:05:30Z
- dc.date.available 2021-03-22T08:05:30Z
- dc.date.issued 2019
- dc.description.abstract Hypercholesterolemia and statins are risk factors for aortic stenosis (AS) and vascular calcification, respectively. Whether heterozygous subjects with familial hypercholesterolemia (HeFH) treated with statins are at risk of AS is unknown. We study the prevalence of AS, aortic valve calcification (AoVC), and aortic sclerosis (ASc) in elderly subjects with HeFH in a prolonged statin treatment. Case-control study, cases were adults ≥65 years of age with a genetic diagnosis of HeFH, LDLc >220 mg/dl, and statin treatment ≥5 years. Controls were relatives of HeFH patients, with LDLc <190 mg/dl. Participants underwent a cardiac ultrasound for aortic valve analysis. We studied 205 subjects, 112 HeFH and 93 controls, with mean age 71.8(6.5) years and 70.0(7.3) years, respectively. HeHF, with respect to controls, presented greater gradients of aortic transvalvular pressure, 7.4(7.3) mmHg versus 5.0(2.8) mmHg, and maximum aortic velocity, 1.7(0.7) m/s versus 1.5(0.4) m/s, and lower aortic valve opening area, 2.0(0.7) cm2 versus 2.4(0.6) cm2 (all p < 0.05). AoVC and ASc were also more prevalent in HeFH (p < 0.05 between groups). Moderate/severe AS prevalence was higher among HeFH: 7.1% versus 1.1% (age- and sex-adjusted odds ratio (OR) 8.33, p = 0.03). Independent risk factors for aortic valve disease in HeFH were age and LDLc before treatment. The number of years under statin treatment was not associated with any aortic valve measurement. Subjects ≥65 years with HeFH in prolonged statin treatment show more aortic valvular disease and higher frequency of AS than controls. Life-long elevated LDLc exposure, rather than time of exposure to statins, explains this higher risk.
- dc.format.mimetype application/pdf
- dc.identifier.citation Marco-Benedí V, Laclaustra M, Casado-Dominguez JM, Villa-Pobo R, Mateo-Gallego R, Sánchez-Hernández RM,et al. Aortic valvular disease in elderly subjects with heterozygous familial hypercholesterolemia: impact of lipid-lowering therapy. J Clin Med. 2019 Dec 14; 8(12): 2209. DOI: 10.3390/jcm8122209
- dc.identifier.doi http://dx.doi.org/10.3390/jcm8122209
- dc.identifier.issn 2077-0383
- dc.identifier.uri http://hdl.handle.net/10230/46875
- dc.language.iso eng
- dc.publisher MDPI
- dc.relation.ispartof Journal of Clinical Medicine. 2019 Dec 14;8(12):2209
- dc.rights Copyright © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword LDL cholesterol
- dc.subject.keyword Aortic sclerosis
- dc.subject.keyword Aortic stenosis
- dc.subject.keyword Aortic valve calcification
- dc.subject.keyword Heterozygous familial hypercholesterolemia
- dc.subject.keyword Statins
- dc.title Aortic valvular disease in elderly subjects with heterozygous familial hypercholesterolemia: impact of lipid-lowering therapy
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion