ArticleJournal of atherosclerosis and thrombosis2022
Factors Associated with Carotid Atherosclerosis and Achilles Tendon Thickness in Japanese Patients with Familial Hypercholesterolemia: A Subanalysis of the Familial Hypercholesterolemia Expert Forum (FAME) Study.
Article in Journal of atherosclerosis and thrombosis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Genetic variants and carotid atherosclerosis progression in familial hypercholesterolemia: a comprehensive review.Frontiers in cardiovascular medicine · 2025Pooled it
- Clinical Impact of Familial Hypercholesterolemia on Lower Extremity Artery Disease in Premature Patients.Annals of vascular diseases · 2026Article
- Assessments of Atherosclerosis and Treatment Strategies for Heterozygous Familial Hypercholesterolemia.Journal of atherosclerosis and thrombosis · 2025Review
- A Comparative Study of Carotid Ultrasound Findings in Patients With and Without Familial Hypercholesterolemia.Cureus · 2025Article
- Clinical Impact of Lipoprotein (a) and Cumulative Low-Density Lipoprotein Cholesterol Exposure on Coronary Artery Disease in Patients with Heterozygous Familial Hypercholesterolemia.Journal of atherosclerosis and thrombosis · 2025Article
- Risk Assessment for Cardiovascular Events using Achilles Tendon Thickness and Softness and Intima-Media Thickness in Familial Hypercholesterolemia.Journal of atherosclerosis and thrombosis · 2024Article
- Early Atherosclerosis in Familial Hypercholesterolemia Patients: Significance of Vascular Markers for Risk Stratification.Journal of cardiovascular development and disease · 2024Article
- Gaps in the Care of Subjects with Familial Hypercholesterolemia: Insights from the Thai Familial Hypercholesterolemia Registry.Journal of atherosclerosis and thrombosis · 2023Article
- Guidelines for the Diagnosis and Treatment of Adult Familial Hypercholesterolemia 2022.Journal of atherosclerosis and thrombosis · 2023Article
- Association between Achilles Tendon Softness and Atherosclerotic Cardiovascular Disease in Patients with Familial Hypercholesterolemia.Journal of atherosclerosis and thrombosis · 2022Article
- Prospective Registry Study of Primary Dyslipidemia (PROLIPID): Rationale and Study Design.Journal of atherosclerosis and thrombosis · 2022Article
- How Can We Identify Very High-Risk Heterozygous Familial Hypercholesterolemia?Journal of atherosclerosis and thrombosis · 2022Review
- Prevalent Coronary Artery Disease and Undertreatment in Heterozygous Familial Hypercholesterolemia -Real-World Data and "Heterozygous FH Score" from FAME Study.Journal of atherosclerosis and thrombosis · 2022Article
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Authors and funding
10 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsFamilial hypercholesterolemia (FH) is characterized by high low-density lipoprotein (LDL) cholesterol levels, xanthomas including Achilles tendon thickening, and premature coronary artery disease (CAD). Carotid intima-media thickness (IMT) is a well-established surrogate marker for CAD in FH and Achilles tendon thickening is a specific physical finding in patients with FH. The objective of the present study was to identify factors associated with carotid IMT and Achilles tendon thickness in FH heterozygotes on lipid-lowering therapy. This study also aimed to examine the follow-up changes in carotid IMT and Achilles tendon thickness among them in the current real-world FH practice.
methodsThe current study is a subanalysis of the Familial Hypercholesterolemia Expert Forum (FAME) Study. The severity of carotid atherosclerosis was assessed with the maximal and mean IMT using ultrasonography, and Achilles tendon thickness was measured using X-rays. The present study used 571 patients under medical treatment for heterozygous FH who had baseline measurements for maximal IMT (n=511), mean IMT (n=459), or Achilles tendon thickness (n=486). The IMT was measured annually, and Achilles tendon thickness was evaluated every two years.
resultsHigher LDL cholesterol (LDL-C) level and lower HDL cholesterol (HDL-C) level were associated with greater maximal and mean IMT as well as greater Achilles tendon thickness. Achilles tendon thickness tended to be greater in patients who had a smoking history than in never-smokers. Maximal IMT and Achilles tendon thickness were significantly greater in patients with CAD than in those without. Additionally, lower HDL-C level and hypertension were associated with higher values of maximal and mean IMT, suggesting the importance of comprehensive risk management including reduced HDL-C and blood pressure control in FH care. In longitudinal observations, percentage changes in maximal IMT and mean IMT gradually increased during the observation period. In contrast, percentage changes in Achilles tendon thickness became progressively thinner throughout the observation period.
conclusionsWe found a positive association between LDL-C levels and severity of carotid atherosclerosis in heterozygous FH patients on treatment. This observation suggests the insufficiency of lipid-lowering therapy and the presence of therapeutic inertia among clinicians in the real-world FH practice.
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