DALLAS – Roughly 10 years after going on statin therapy as children or adolescents, a group of Dutch patients with familial hypercholesterolemia already has a significantly lower cardiovascular event rate than their affected parents did at the same age.
"Statin therapy in childhood seems to be effective in reducing CHD [coronary heart disease] risk in individuals with FH [familial hypercholesterolemia], although longer follow-up is needed to confirm these results," Dr. Marjet J.A.M. Braamskamp declared at the American Heart Association scientific sessions.
The 214 Dutch youths with FH started on statin therapy at age 8-18 years as part of a randomized clinical trial. None has experienced a cardiovascular event by age 30. In contrast, their affected parents, for whom statins weren’t available until they were well into adulthood, already had a 7% CHD event rate by age 30, a statistically significant difference, reported Dr. Braamskamp of the Academic Medical Center, Amsterdam.
In an interview, she said the plan is to continue to follow this cohort of young adults who started statin therapy in childhood at least until age 50. By that age, 55% of their fathers with FH and 24% of their mothers with FH had known CHD. While none of the FH mothers died of CHD before age 60, 16% of the FH fathers did, at an average age of 35.9 years.
Current European and American guidelines recommend statin therapy starting at age 8 or 10 years in children with the molecular or clinical diagnosis of FH and elevated cholesterol levels. Those guidelines were issued based upon recognition that children with FH have elevated cholesterol levels from birth onward, coupled with evidence from short-term randomized trials demonstrating that statins are safe and effective for lipid-lowering in such patients. The Dutch follow-up study provides evidence to suggest this early-treatment strategy also pays off in terms of reduced CHD risk.
The study was supported by the Dutch Heart Foundation. Dr. Braamskamp reported having no financial conflicts.