Samuel S. Gidding, MD FH Foundation Pasadena, CA

Even in Specialty Clinics, LDL Goals Hard To Reach and Atherosclerotic Events High Interview with:

Samuel S. Gidding, MD FH Foundation Pasadena, CA

Dr. Gidding

Samuel S. Gidding, MD
FH Foundation
Pasadena, CA What is the background for this study?

Response: Patients with familial hypercholesterolemia are at high risk for atherosclerotic heart disease but little is known about intensification of treatment and event rates in lipid specialty care in the United States.

We examined data on 1900 patients, enrolled in the CASCADE FH Registry,sponsored by the Familial Hypercholesterolemia Foundation, to determine if cholesterol lowering therapy increased to improve getting patients to a lower LDL cholesterol and to look at incident cardiac events in tow groups, those with prior heart disease and those without. What are the main findings? 

Response: In specialty care, lower LDL cholesterol was achieved in many patients by increasing treatment, most efficacious were PCSK9 inhibitors; However, many patients, despite several medications were unable to get to goal.

Atherosclerotic event rates were high, 2.2/100 patient years.  Those with prior heart disease had 5 times the event rate of those with no prior heart disease. What should readers take away from your report?

Response: Familial hypercholesterolemia is a high risk condition. Specialty care helps patients get to goal.  More emphasis needs to be placed on treatment earlier in life given the very high event rate in those with prior heart disease and treatment started later in life. What recommendations do you have for future research as a result of this work?

Response: Research on treatment earlier in life to prevent first events.  Studies to better risk stratify patients at the highest risk for more intensive treatment.

FH Foundation funded and supported the study.


Longitudinal low density lipoprotein cholesterol goal achievement and cardiovascular outcomes among adult patients with familial hypercholesterolemia: The CASCADE FH registry

Duell, P. Barton et al.

Atherosclerosis, Volume 289, 85 – 93 


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Last Updated on September 18, 2019 by Marie Benz MD FAAD