Observational studyGlobal heart2026
Stepwise Targeted Screening for Familial Hypercholesterolemia in a Resource-Limited Setting: A Scalable Model Linking Premature Coronary Artery Disease and Community Screening in Vietnam.
Observational study in Global heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Familial hypercholesterolemia (FH) is a common autosomal dominant disorder associated with a substantially increased risk of atherosclerotic cardiovascular disease. In low- and middle-income countries (LMICs), universal FH screening is often impractical, highlighting the need for targeted screening strategies embedded within existing health systems. Objectives: To evaluate the detection yield and real-world implementation feasibility of a stepwise targeted FH screening strategy in a resource-limited setting. Methods: This multi-component implementation study included retrospective and prospective hospital-based screening of patients with premature coronary artery disease (CAD), followed by a geographically targeted community-based screening program linked to a genetically confirmed FH index case in Vietnam. FH was assessed using the Dutch Lipid Clinic Network criteria, with LDL-C thresholds applied for community-level screening. Results: Among patients with premature CAD, phenotypic FH was identified in 2.5% and 8.3% of the retrospective and prospective cohorts, respectively. The higher detection rate in the prospective cohort may reflect more systematic phenotyping. In the community screening, 59.1% of eligible individuals participated, and 10.6% had LDL-C levels ≥ 4.9 mmol/L. Conclusions: A stepwise targeted FH screening strategy-initiated in clinical populations and extended via geographically targeted community screening-demonstrates feasibility and potential scalability in resource-limited settings and may provide a pragmatic framework for integration into national NCD programs in LMICs. Highlights: - Targeted screening strategies may enhance the detection of FH in resource-limited settings where universal screening is not feasible.- Patients with premature coronary artery disease represent a high FH detection rate.- Geographically targeted community-based screening linked to FH index cases enables identification of individuals with markedly elevated LDL-C levels.- A stepwise approach combining hospital-based and community-based screening may provide a scalable model for FH detection in LMICs.
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