SAFEHEART risk-equation and cholesterol-year-score are powerful predictors of cardiovascular events in French patients with familial hypercholesterolemia.
Cardiovascular risk
Cardiovascular risk equation
Cholesterol-year-score
Familial hypercholesterolemia
Primary cardiovascular prevention
Journal
Atherosclerosis
ISSN: 1879-1484
Titre abrégé: Atherosclerosis
Pays: Ireland
ID NLM: 0242543
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
15
04
2020
revised:
12
06
2020
accepted:
17
06
2020
pubmed:
21
7
2020
medline:
1
6
2021
entrez:
21
7
2020
Statut:
ppublish
Résumé
Patients with heterozygous familial hypercholesterolemia (HeFH) present elevated cardiovascular (CV) risk. Current CV risk stratification algorithms developed for the general population are not adapted for heFH patients. It is therefore of singular importance to develop and validate CV prediction tools, which are dedicated to the HeFH population. Our first objective was to validate the Spanish SAFEHEART-risk equation (RE) in the French HeFH cohort (REFERCHOL), and the second to compare SAFEHEART-RE with the low-density-lipoprotein-cholesterol (LDL-C)-year-score for the prediction of CV events in the HeFH French population. We included HeFH (n = 1473) patients with a genetic or clinical diagnosis (DLCN score ≥8). Among them, 512 patients with a 5-year follow-up were included to validate the 5 year-CV-RE. A total of 152 events (10.3%) occurred in the entire population of 1473 patients during a mean follow-up of 3.9 years. Over the five-year follow-up, non-fatal CV events occurred in 103 patients (20.2%). Almost all the parameters used in the SAFEHEART-RE were confirmed as strong predictors of CV events in the REFERCHOL cohort. The C-statistic revealed a satisfactory performance of both the SAFEHEART-RE and LDL-C-year-scores in predicting CV events for all the patients (primary and secondary prevention) (C-index 0.77 and 0.70, respectively) as well as for those in primary prevention at inclusion (C-index 0.78 and 0.77, respectively). This analysis represents the first external validation of the SAFEHEART-RE and demonstrated that both SAFEHEART-RE and the LDL-C-year-score are good predictors of CV events in primary prevention HeFH patients.
Sections du résumé
BACKGROUND AND AIMS
Patients with heterozygous familial hypercholesterolemia (HeFH) present elevated cardiovascular (CV) risk. Current CV risk stratification algorithms developed for the general population are not adapted for heFH patients. It is therefore of singular importance to develop and validate CV prediction tools, which are dedicated to the HeFH population.
METHODS
Our first objective was to validate the Spanish SAFEHEART-risk equation (RE) in the French HeFH cohort (REFERCHOL), and the second to compare SAFEHEART-RE with the low-density-lipoprotein-cholesterol (LDL-C)-year-score for the prediction of CV events in the HeFH French population.
RESULTS
We included HeFH (n = 1473) patients with a genetic or clinical diagnosis (DLCN score ≥8). Among them, 512 patients with a 5-year follow-up were included to validate the 5 year-CV-RE. A total of 152 events (10.3%) occurred in the entire population of 1473 patients during a mean follow-up of 3.9 years. Over the five-year follow-up, non-fatal CV events occurred in 103 patients (20.2%). Almost all the parameters used in the SAFEHEART-RE were confirmed as strong predictors of CV events in the REFERCHOL cohort. The C-statistic revealed a satisfactory performance of both the SAFEHEART-RE and LDL-C-year-scores in predicting CV events for all the patients (primary and secondary prevention) (C-index 0.77 and 0.70, respectively) as well as for those in primary prevention at inclusion (C-index 0.78 and 0.77, respectively).
CONCLUSIONS
This analysis represents the first external validation of the SAFEHEART-RE and demonstrated that both SAFEHEART-RE and the LDL-C-year-score are good predictors of CV events in primary prevention HeFH patients.
Identifiants
pubmed: 32688103
pii: S0021-9150(20)30318-X
doi: 10.1016/j.atherosclerosis.2020.06.011
pii:
doi:
Substances chimiques
Cholesterol, LDL
0
Cholesterol
97C5T2UQ7J
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
41-49Investigateurs
Denis Angoulvant
(D)
Sophie Beliard
(S)
Franck Boccara
(F)
Eric Bruckert
(E)
Bertrand Cariou
(B)
Valérie Carreau
(V)
Alain Carrie
(A)
Sybil Charriere
(S)
Yves Cottin
(Y)
Mathilde DI Filippo
(MD)
Sonia Dulong
(S)
Vincent Durlach
(V)
Michel Farnier
(M)
Emile Ferrari
(E)
Dorota Ferrieres
(D)
Jean Ferrieres
(J)
Antonio Gallo
(A)
Philippe Giral
(P)
Sophie Gonbert
(S)
Regis Hankard
(R)
Jocelyn Inamo
(J)
Olga Kalmykova
(O)
Michel Krempf
(M)
Philippe Moulin
(P)
François Paillard
(F)
Noel Peretti
(N)
Agnes Perrin
(A)
Jean Pierre Rabes
(J)
Ariane Sultan
(A)
Patrick Tounian
(P)
René Valero
(R)
Bruno Verges
(B)
Cecile Yelnik
(C)
Olivier Ziegler
(O)
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.