Screening for Subclinical Atherosclerosis in Patients with Familial Hypercholesterolemia: Insights and Implications

Background/Objectives: Familial hypercholesterolemia (FH) is a monogenic dyslipidemia that leads to early cardiovascular events. Subclinical atherosclerosis refers to the formation of atheromatous plaques in arterial territories before any clinical events. In our study, we investigated the presence, extent and independent predictors of subclinical atherosclerosis among patients diagnosed with FH. Methods: This was a single-center, prospective and cross-sectional study involving a cohort of 215 patients diagnosed with FH. Carotid and femoral ultrasonography were performed, and coronary artery calcium score was measured to screen for subclinical atherosclerosis. Apolipoprotein A-I, apolipoprotein B and Lipoprotein (a) were analyzed using the nephelometric method. Results: The study cohort comprised 136 females (63%) with a mean age of 54 (43–62) years. The stigmata rate was 18%. The rate of statin use during subclinical atherosclerosis screening was 32% and only eight patients (4%) attained LDL-C values