Utility of Dutch Lipid Clinic Network Score to Estimate Prevalence of Familial Hypercholestrolemia in Patients with ST-Elevation Myocardial Infarction

• Main Authors: Han Bing, Chow, H. S., Ling, B. K., Chung, L. K., Then, I. X., Pang, L. S., Chen, C. D., Bhavnani, C. T., Tan, Y. Y., Oon, K. T., Koh, Y. L., Cham, A. Y. Y., Fong, Asri, Said, T. K., Ong
• Format: Article
• Language: English
• Published: Elsevier B.V. 2021
• Subjects: R Medicine (General)
• Online Access: http://ir.unimas.my/id/eprint/41005/3/Utility.pdf; http://ir.unimas.my/id/eprint/41005/; https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0167527321016211?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0167527321016211%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.internationaljournalofcardiology.com%2F
• Institution: Universiti Malaysia Sarawak

Background Hypercholesterolaemia is prevalent in the Malaysian population, and its treatment control rates remain suboptimal1. Familial hypercholesterolemia (FH) is an autosomal dominant condition that leads to accelerated arteriosclerotic cardiovascular disease (ASCVD). The prevalence of FH in the general population worldwide has been postulated to be 1:3132 and 1:100 in the Malaysian community3. It has been proposed that lipid lowering treatment prevents further increase in total cardiovascular risk of FH patients, and this recommendation is extensible for FH patients plus atherosclerotic CAD (coronary artery disease). However, despite its implication in CAD, FH is still an underdiagnosed and undertreated condition2-4. To date, the prevalence of FH in the STEMI (ST-elevation myocardial infarction) population in Malaysia is not studied. Establishing the prevalence of FH among patients with CAD and comparing this with the general population would help future efforts at identifying subjects with FH. Objective We aim to estimate the prevalence of FH in patients with STEMI in Sarawak using Dutch Lipid Clinic Network (DLCN) score. Materials and Methods Patients who were admitted for type-1 STEMI from April 2021 until July 2021 to Pusat Jantung Sarawak were recruited. History taking and physical examination were carried out on-site. FH was screened clinically using DLCN score. Results Out of the recruited patients, 45% of the cohort was clinically categorized into probable/ possible FH without genetic testing. Mean age and low density lipoprotein (LDL) were 52.7 and 3.38mmol/l respectively. Prevalence of premature CAD was 63%. Male gender, smoking, high BMI was the most frequent risk factor observed. Conclusions Prevalence of probable/possible familial hypercholesterolemia in a STEMI cohort using DLCN score is 45%. DLCN score in the STEMI cohort is not related to LDL levels.