Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: an analysis from the HELLAS-FH registry

Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed. Patients with FH were recruited by a network of Greek sites participating in the HELLAS-FH registry. LDL-C levels were calculated using the Friedewald (LDL-C ) and the Martin/Hopkins (LDL-C ) equations as well as after correcting LDL-C for Lp(a) levels [LDL-C ]. The objective was to compare LDL-C levels and target achievement as estimated by different methods in FH patients. This analysis included 1620 patients (1423 adults and 197 children). In adults at diagnosis, LDL-C and LDL-C levels were similar [235 ± 70 mg/dL (6.1 ± 1.8 mmol/L) vs 235 ± 69 mg/dL (6.1 ± 1.8 mmol/L), respectively; P = NS], while LDL-C levels were non-significantly lower than LDL-C [211 ± 61 mg/dL (5.5 ± 1.6 mmol/L); P = 0.432]. In treated adults (n = 966) both LDL-C [150 ± 71 mg/dL (3.9 ± 1.8 mmol/L)] and LDL-C levels [151 ± 70 mg/dL (6.1 ± 1.8 mmol/L); P = 0.746] were similar, whereas LDL-C levels were significantly lower than LDL-C [121 ± 62 mg/dL (3.1 ± 1.6 mmol/L); P