Lipid-lowering therapy in patients with familial hypercholesterolemia in the real-life clinical practice

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To evaluate the efficacy of lipid-lowering therapy in patients with heterozygous familial hypercholesterolemia (FH) in the real-life clinical practice.

Material and methods

We retrospectively studied adult patients ( 18 years) with heterozygous familial hypercholes≥ terolemia (FH) from the Karelian registry. FH was diagnosed according to the Dutch Lipid Clinic Network criteria. The diagnosis of FH was considered “definite“, “probable“ or “possible“ if the total score was >8, 6-8 or 3-5, respectively. The doses of statins were defined as high (atorvastatin 40-80 mg or rosuvastatin 20-40 mg), medium (rosuvastatin 10-15 mg or atorvastatin 20-30 mg) and low (atorvastatin 10 mg, rosuvastatin 5 mg or simvastatin 20-40 mg).


191 patients were enrolled in the retrospective study (75 males, mean age 50.0±1.1 years). 124 of them (64.9%) were treated with statins. High, medium and low doses of statins were used in 31 (25.0%), 25 (20.1%) and 68 (54.8%) of patients, respectively. Target LDL cholesterol levels were achieved only in 19.4-20.0% of patients with FH, who were treated even with high or medium doses of statins.


In clinical practice, statins, even at high doses, rarely provide lipid target values in patients with FH who frequently require lipid-lowering therapy with a different mechanism of action, particularly PСSK9.CSK9 inhibitors.

Key words

Familial,hypercholesterolemia,lipid-lowering therapy,PСSK9 inhibitors, cardiovascular risk.