Factors Predicting Statin Initiation During Childhood in Familial Hypercholesterolemia: Importance of Genetic Diagnosis - Inserm - Institut national de la santé et de la recherche médicale
Article Dans Une Revue The Journal of Pediatrics Année : 2023

Factors Predicting Statin Initiation During Childhood in Familial Hypercholesterolemia: Importance of Genetic Diagnosis

1 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
2 HFME - Hôpital Femme Mère Enfant [CHU - HCL]
3 GHE - Groupement Hospitalier Lyon-Est
4 IRSD - Institut de Recherche en Santé Digestive
5 Equipe Vieillissement (CERPOP)
6 Service Cardiologie [CHU Toulouse]
7 CHU Trousseau [APHP]
8 SU - Sorbonne Université
9 CRSA - Centre de Recherche Saint-Antoine
10 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
11 GRC 22 - C²MV - Groupe de recherche clinique Complications Cardiovasculaires et Métaboliques chez les patients vivant avec le Virus de l’immunodéficience humaine (VIH)
12 HCL - Hospices Civils de Lyon
13 Hôpital Louis Pradel [CHU - HCL]
14 Service de Cardiologie [CHU de Dijon]
15 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
16 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
17 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
18 ITX-lab - ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291
19 UBFC - Université Bourgogne Franche-Comté [COMUE]
20 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
21 Hôpital de Hautepierre [Strasbourg]
22 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
23 Service de médecine interne [Lille]
24 IHU ICAN - Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière]
25 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
26 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
Alexandre Vimont
  • Fonction : Auteur

Résumé

OBJECTIVE: To identify childhood and parental factors associated with initiation of statin therapy in children with heterozygous familial hypercholesterolemia (HeFH), including underlying genetic diagnosis or parental premature atherosclerotic cardiovascular disease (ASCVD). STUDY DESIGN: This multicenter cohort study included 245 HeFH child-parent pairs from the REFERCHOL national register (2014-2020). Demographic and clinical characteristics at the last visit were collected. Vascular disease in parents was defined as a history of ASCVD, and/or a coronary artery calcium score \textgreater100, and/or stenosis of \textgreater50% in at least carotid artery. Statistical analyses included descriptive analysis, logistic regression for univariate and multivariate effects of statins, and a sensitivity analysis combining the characteristics of children and parents. RESULTS: Among the 245 children in the study cohort, 135 (58%), with a mean age of 14 ± 3 years, were treated with a statin. In multivariable analysis, the predictive childhood factors associated with statin treatment were genetic diagnosis (OR, 2.5; 95% CI, 1.3 to 4.9; P = .01), older age (OR, 4.4; 95% CI, 1.8-10.6; P = .01), more than 2 visits (OR, 2.36; 95% CI, 1.18-4.73; P = .015), and longer duration of follow-up (OR, 1.3; 95% CI, 1.1-1.6; P \textless .001). The predictive parental factor associated with childhood treatment was the presence of vascular disease (OR, 2.4; 95% CI, 1.0-5.7; P = .04). CONCLUSIONS: HeFH confirmed by DNA testing during childhood and a history of vascular disease in parents were independently associated with statin treatment in children with HeFH. Genetic diagnosis may be useful for cardiovascular prevention in children.

Dates et versions

inserm-03958022 , version 1 (26-01-2023)

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Citer

N. Peretti, Alexandre Vimont, E. Mas, Jean Ferrières, P. Tounian, et al.. Factors Predicting Statin Initiation During Childhood in Familial Hypercholesterolemia: Importance of Genetic Diagnosis. The Journal of Pediatrics, 2023, 253, pp.18-24. ⟨10.1016/j.jpeds.2022.08.041⟩. ⟨inserm-03958022⟩
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