Page 6 - reflections_dyslipidaemia_newsletter7_2024

REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #7 2024

The authors also describe the study design for the randomized controlled PRECAD (Prevent Coronary Artery Disease) trial which
aims to assess the potential benefit of an aggressive control of CV risk factors in otherwise healthy young adults. The hypothesis of
PRECAD is that in subjects aged 20 to 39 years without known
Dyslipidaemia
CVD, maintaining LDL-C <70 mg/dL and strict control of BP
and glucose will prevent the onset of atherosclerosis and/or its
progression.

In the standard of care arm, participants will follow guideline-
directed medical therapy with follow-up every year. In the
active treatment arm, specific measures will be implemented
to achieve the goals of LDL-C <70 mg/dL, SBP <120 mmHg,
and HbA1c <6.5%, including the use of inclisirin, a PCSK-9i, ±
statin ezetimibe combination. The authors note that biannual
administration is expected to increased adherence in this group
of young participants, and the effects of PCSK-9i starting at
a young age may delay or prevent the onset of symptomatic
CVD. Atherosclerotic burden and extent will be assessed by
three-dimensional (3D) vascular ultrasound of the right and left
carotid and femoral arteries at baseline, and at 2.5-year and at
five-year follow-up.

The authors conclude that the PRECAD trial may provide
actionable support for early and aggressive CV risk factor
intervention to improve long-term CV prognosis in a healthy,
but potentially vulnerable segment of the population.

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Familial hypercholesterolaemia in children and adolescents from 48 countries: a

cross-sectional study.
European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration. Lancet. 2024 Jan 6;403(10421):55-66.

Although there is agreement among healthcare professionals that early identification and management of familial
hypercholesterolaemia (FH) is important for preventing associated CVD, early detection, particularly in childhood and adolescence,
remains challenging. The Familial Hypercholesterolaemia Studies Collaboration is a global registry that aims to assess identification
and management of children and adolescents with FH. This study included 63,093 individuals with FH, of whom 11,848 were children
or adolescents younger than 18 years from 48 countries.

The authors found that there were differences among country income groups, with LDL-C measurement and genetic confirmation
less common in non-high-income countries. Countries were classified by income status according to the World Bank definition of 2023.

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