The Prevalence and Diagnostic Ratio of Familial Hypercholesterolemia (FH) and Proportion of Acute Coronary Syndrome in Japanese FH Patients in a Healthcare Record Database Study.

BACKGROUND

Familial hypercholesterolemia (FH) is a genetic disorder characterized by high levels of low-density lipoprotein cholesterol (LDL-C). Because of underdiagnosis, acute coronary syndrome (ACS) is often the first clinical manifestation of FH. In Japan, there are few reports on the prevalence and diagnostic ratios of FH and the proportion of ACS among FH patients in clinical settings.

METHODS

This retrospective, observational study used anonymized data from electronic healthcare databases between April 2001 and March 2015 of patients who had ≥2 LDL-C measurements recorded after April 2009. The index date was defined as the date of the first LDL-C measurement after April 2009. The primary endpoint was the prevalence of definite or suspected FH; secondary endpoints included the proportion of FH patients hospitalized for ACS, the proportion of patients using lipid-lowering drugs (LLDs), and LDL-C levels.

RESULTS

Of the 187,781 patients screened, 1547 had definite or suspected FH (0.8%) based on data from the entire period; 832 patients with definite (

CONCLUSIONS

The prevalence of FH in this Japanese cohort of patients with ≥2 LDL-C measurements at hospitals was 0.8%, which is higher than that currently reported in epidemiological studies (0.2-0.5%). Patients with suspected FH, with or without ACS, had poorly controlled LDL-C levels and were undertreated. The proportion of FH patients who were hospitalized due to ACS was 7.2%.

Informations de copyright

Copyright © 2020 Tamio Teramoto et al.

Déclaration de conflit d'intérêts

Tamio Teramoto received honoraria from Bayer Yakuhin, Ltd., Pfizer Japan Inc., Takeda Pharmaceutical Company Limited, Astellas Pharma Inc., Kowa Company, Ltd., Sanofi K.K., MSD K.K., Amgen Astellas BioPharma K.K., and AstraZeneca K.K.; received fees for promotional materials from Daiichi Sankyo Company Limited; received clinical research funding from Amgen Astellas BioPharma K.K.; received scholarship grants from Daiichi Sankyo Company Limited, Takeda Pharmaceutical Company Limited, Astellas Pharma Inc., Kissei K.K., and Shionogi & Co., Ltd.; and belongs to courses endowed by Kowa Company, Ltd., MSD K.K., and Bayer Yakuhin, Ltd. Tomohiro Sawa received clinical research funding from Amgen Astellas BioPharma K.K. Satoshi Iimuro received clinical research funding from Amgen Astellas BioPharma K.K., Public Health Research Foundation, Kanebo Cosmetics, Japan Medical Agency, Japan Heart Foundation, Toho University, and Asahi Kasei Pharma Corporation; and received other non–research-related compensation from EP - CRSU Co., Ltd., and Chugai Pharmaceutical Co., Ltd. Hyoe Inomata was an employee of Amgen Astellas BioPharma K.K. and a stockholder of Amgen Inc. at the time this study was conducted. Takashi Koshimizu and Katsutoshi Hiramatsu are employees of Amgen K.K. and were employees of Amgen Astellas BioPharma K.K. at the time this study was conducted and stockholders of Amgen Inc. Iori Sakakibara was a full-time employee of Amgen Astellas BioPharma K.K. at the time this study was conducted.