Familial-combined hyperlipidaemia in very young myocardial infarction survivors (<=40 years of age)

Abstract

The present study suggests that the FCHL phenotype seems to be a major risk factor for the occurrence of MI at a very young age. It remains to be determined whether this excessively increased risk can be favourably modified by therapeutic interventions.

Triglycerides and Cardiovascular Disease

“…140 -142 Importantly, FCHL is strongly represented in studies of survivors of myocardial infarction, 87 especially those survivors Ͻ40 years of age. 143 The increased frequency with which FCHL is seen may relate in part to the observation 144 that in addition to multiple genes that upregulate apo B secretion, the worldwide trend of energy excess and associated weight gain exaggerates the baseline abnormalities in apo B secretion. Although the phenotypic expression of FCHL is delayed until young adulthood, as childhood obesity rates increase, the higher adipose tissue mass that drives apo B secretion accelerates the number of cases of FCHL diagnosed in the young adult population.…”

“…148,230 As reviewed recently, 231 many epidemiological studies have compared the predictive value of apo B with non-HDL-C for CVD outcomes and have more commonly identified apo B to be either superior or equivalent to non-HDL-C, whereas non-HDL-C has only been more predictive in limited cases. 143 Yet in studies that demonstrated statistically significant differences between apo B and non-HDL-C, the differences in point estimates were often quite small and therefore unlikely to have a major impact in day-to-day clinical practice. 231 Consequently, the ATP III guidelines favored use of non-HDL-C rather than apo B; this was related in part to the limited availability of apo B assays in clinical laboratories, compounded by the relative lack of standardization of the apo B assay and higher cost than for non-HDL-C. 221 Nevertheless, in view of additional data and in the presence of standardization that has accrued since ATP III was released in 2001, a panel of international experts has recommended a revision of this assessment.…”

An International Atherosclerosis Society Position Paper: Global recommendations for the management of dyslipidemia

“…Observational evidence strongly suggests that mixed hyperlipidemia (elevated LDL-C + elevated VLDL-C) raises risk more than high LDL-C alone (Frick et al 1987;Wiesbauer et al 2009). Therapy of mixed hyperlipidemia is simplified by making non-HDL-C the treatment target.…”

Elevated risk of myocardial infarction in very young immigrants from former Yugoslavia

“…The study population and methodology have been described previously [6]. Infarction patients were prospectively recruited from two Viennese hospitals within 6 days of infarction.…”