Identification of familial hypercholesterolemia in patients with myocardial infarction: A Chinese cohort study

- The prevalence of FH in Chinese patients with MI appeared common, particularly in those with pMI.
- Phenotypic FH increased significantly and independently the risk of the early onset of MI.
- FH needed to be identified in patients with MI as they were less likely to reach target LDL-C levels.

BackgroundFamilial hypercholesterolemia (FH) is marked by an elevated plasma cholesterol and risk of premature cardiovascular disease. An increased burden of FH is being realized.ObjectiveTo provide data on FH in Chinese patients with myocardial infarction (MI) and its potential contribution to early MI.MethodsA total of 1843 consecutive patients undergoing coronary angiography with their first MI were recruited. The clinical FH was diagnosed using the Dutch Lipid Clinic Network criteria. The prevalence and clinical features of FH and the relationship of FH to risk of early MI were investigated.ResultsOf the 1843 patients, 48.2% were detected as premature MI (pMI, the onset age ≤55 years for men, ≤60 years for women). The prevalence of definite/probable FH reached 3.9% (7.1% in pMI and 0.9% in non-pMI). Furthermore, we found that the risk of pMI was significantly elevated in both definite/probable FH (vs. unlikely FH, odds ratio, 5.05 [1.10-23.23]) and possible FH (vs unlikely FH, odds ratio, 2.65 [1.22-5.77]), independently from classical risk factors and medications. Additionally, patients with definite/probable FH occurred 10 years younger than those with unlikely FH in the onset age of MI (48.63 ± 1.20 vs 58.35 ± 0.30 years, P < .001). When considered in subgroup of pMI or non-pMI, an early onset of MI was also observed in definite/probable FH (pMI, 45.83 ± 0.89 vs 47.87 ± 0.34 years; non-pMI, 60.75 ± 1.96 vs 65.07 ± 0.22 years; both P < .05).ConclusionThe prevalence of FH among Chinese patients with MI appeared common, particularly among those with pMI. The phenotypic FH might significantly promote the early onset of MI.