Prevalência de hipercolesterolemia familiar em ambulatório de doença arterial coronariana do Hospital Ana Nery (Salvador – Bahia, Brasil)

Abstract

Introduction: Familial hypercholesterolemia (HF) is a silent genetic disease that affects lipid metabolism, increasing circulating LDL-cholesterol (LDL-C) levels and promotes the development of atherosclerosis. There is a paucity of data in the literature on the prevalence of this pathology in patients with coronary artery disease in Brazil. Objectives: To obtain data on the prevalence of FH in patients at high risk of cardiovascular events followed at the outpatient clinic specialized in coronary artery disease at the Hospital Ana-Nery - Salvador-BA. Methodology: Cross-sectional study of the prevalence of HF. We included patients with acute coronary syndrome (ACS) for less than 1 year and patients with symptomatic coronary artery disease with indication for revascularization procedures (surgical or percutaneous). Demographic and laboratory data were collected (admission) and followed up at 6 and 12 months. The selected patients were included in a specialized outpatient clinic with a multidisciplinary approach, and a goal of reducing recurrent cardiovascular events. As a diagnostic criterion for HF, the Dutch Lipid Clinic Network was used, and the patients were divided into two groups: HF Group (> 5 points), Non-HF Group (<5 points). Outcomes: Between March 2017 and September 2018, a total of 217 patients were followed up at the outpatient clinic. Of these, 131 (60.4%) were males, the mean age being 62.5 (± 11.1) years. Most patients (123, equivalent to 56.7%) had presented ACS in the last 12 months, and 104 (48%) were diabetic. A total of 145 patients presented all the data available for the Dutch calculation, of which 4 (2.8%) presented the diagnosis of HF certainty, 9 (6.2%) as probable HF and 44 (30.3%). with diagnosis of possible HF. Patients in the HF group (> 5 points) tended to be younger, 58 (± 12) vs 64 (± 11) years, p = 0.016; and had higher LDL-C values, 147 (± 44) vs 74 (± 26) mg / dL, p <0.0001. Conclusion: In a population with a very high cardiovascular risk, familial hypercholesterolemia presented a considerable prevalence based on clinical criteria. Correct identification of these patients is imperative in view of being younger patients at high risk for recurrent events due to the difficult control of LDL-c.