Prevalence, characteristics and management of patients with familial hypercholesterolemia and acute myocardial infarction: Data from the RICO survey

Background and aim Familial hypercholesterolemia (FH) is at very high risk of early myocardial infarction (MI). However, coronary artery disease (CAD) burden of FH in acute MI remains unclear. From a large database of a regional registry of acute MI, we aimed to address FH prevalence and CAD characteristics. Methods Consecutive patients with AMI in the multicentre database (RICO survey) from 2001–2017 were considered. An algorithm, adapted from Dutch lipid clinic network criteria, was built upon 4 variables [LDL-cholesterol (C) level and chronic lipid lowering agents, premature and family history of CAD] to identify FH probabilities. Results Among the 11,624 patients included in the RICO survey, 249(2.1%) had probable/definite FH (score ≥ 6), and 2405(20.7%) had possible FH (score 3–5). When compared with patients without FH (score 0–2), FH patients (score ≥ 6) were ≈ 20y younger [51(46–57) vs. 71(61–80)y, P P P P P P P P P P P Conclusion In this large real world population of acute MI, a high prevalence of FH was found. Moreover, FH patients were characterized by their young age associated with the severity of CAD burden and limited use of preventive lipid lowering therapy, suggesting the opportunity for prevention strategies.