Dear Editor,
Paraskevas et al.Citation1 expand on the theme of our reviewCitation2. Our main objective was to consider the substantial evidence showing that patients with familial hypercholesterolaemia (FH) have a high risk of developing non-coronary vascular diseaseCitation2.
Paraskevas et al.Citation1 add to the evidence we presentedCitation2 from the point of view of vascular surgeons. Thus, FH patients can present to vascular specialists at a younger age, with more extensive non-coronary vascular disease and also have a worse prognosis after vascular interventions than patients without FH.
We would like to underline that a patient presenting to a vascular specialist may be an opportunity to make a diagnosis of FH. Therefore, awareness among vascular specialists is important.
Because of heightened awareness, more patients with FH are likely to be diagnosed and treated early. This may decrease their risk of developing non-coronary vascular disease. On the other hand, effective treatment will prolong the survival of patients with FH. In turn, this may increase their risk of developing non-coronary vascular disease. Whatever the pattern, vascular specialists need to know that these patients form a special group with their own characteristics and outcomes.
We also suggest that more attention (and research) should be given to any benefit that may follow “statin loading” before any vascular interventionCitation3. This suggestion would not only apply to patients with FH.
Contact with a vascular specialist may also prove to be an opportunity to improve adherence to treatment for FH. This should also involve risk factors other than raised low-density lipoprotein cholesterol levels.
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Declaration of funding
No funding to disclose.
Declaration of financial/other relationships
D.P.M. has disclosed that he has given talks and attended conferences sponsored by Amgen, Novo Nordisk and Libytec. No potential conflict of interest was reported by the other authors.
Acknowledgements
None reported.
References
- Paraskevas KI, Liapis CD, Veith FJ. Outcomes in patients with familial hypercholesterolaemia undergoing vascular surgical procedures. Curr Med Res Opin. 2020. DOI:10.1080/03007995.2020.1776236
- Anagnostis P, Vaitsi K, Mintziori G, et al. Non-coronary atherosclerotic cardiovascular disease in patients with familial hypercholesterolaemia. Curr Med Res Opin. 2020;36(5):731–740.
- Katsiki N, Triposkiadis F, Giannoukas AD, et al. Statin loading in cardiovascular surgery: never too early to treat. Curr Opin Cardiol. 2018;33(4):436–443.