From the Editors
AHA Agenda on FH: Addressing the burden of underdiagnosed and undertreated FH
Underdiagnosed and undertreated familial hypercholesterolaemia (FH, inherited high cholesterol), is an important contributor to overall coronary heart disease (CHD) death and disability. This issue is clearly highlighted by a study presented at the American Heart Association Scientific Sessions 2015 (1). The investigators used a Markov…
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LDL apheresis: Don’t throw the baby out with the bathwater!
Peter Lansberg1,2,3 Wolfgang Ramlow1 1Apheresis Center Rostock (ACR), Germany 2Center for Translational Molecular Medicine – Translational Research IT (CTMM-TraIT), Eindhoven Netherlands 3Department of Vascular Medicine Academic Medical Center Amsterdam, Netherlands Will LDL apheresis become redundant after the introduction of PCSK9 targeted treatments? This new lipid…
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PCSK9 expression in extrahepatic tissues: what is the potential relevance?
Proprotein convertase subtilisin-kexin 9 (PCSK9), the last member of the proprotein convertase family (1) discovered in 2003, has been shown to be highly expressed in liver (2). Subsequent genetic studies showed that PCSK9 was related to the regulation of circulating low-density lipoprotein (LDL) cholesterol in…
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‘High-intensity cholesterol-lowering therapy’ versus ‘high-intensity statin therapy’
Is it time to change the paradigm? Recent guidelines come under scrutiny from Professor Luis Masana, University Rovira and Virgili, Reus-Tarragona, Spain The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on cholesterol management for cardiovascular disease prevention identified four groups of patients that…
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New era in cholesterol-lowering? PCSK9 inhibitors soon available?
European authority (CHMP) has recommended regulatory approval of the first PCSK9 inhibitor, opening the way to a new era of lowering LDL-cholesterol treatment for people with a high risk of heart attacks and strokes. The importance of this development and possible implications for patients with…
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Does the mechanism of lowering LDL cholesterol matter? Insights from recent Mendelian Randomization studies
Meta-analyses of numerous randomized trials have demonstrated that lowering low density lipoprotein (LDL) cholesterol by inhibiting HMG-CoA reductase (HMGCR) with a statin reduces the risk of major cardiovascular events by approximately 20% for each mmol/L lower LDL cholesterol.1 However, several randomized trials have failed to…
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FH – the challenges for the next 10 years?
Kees Hovingh, Academic Medical Center, Amsterdam, the Netherlands In a session on familial hypercholesterolaemia (FH, inherited high cholesterol) at the 83rd Annual Congress of the European Atherosclerosis Society (EAS), Dr Kees Hovingh outlined what he saw as the challenges for FH in the next decade….
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FH in the statin era: we need to do better
Despite the availability of generic statin therapy, cardiovascular disease accounts for 50% of all deaths in FH patients. Clinicians need to do better, argues Eric Bruckert, Institut E3M et IHU cardiométabolique (ICAN), Hôpital Pitié Salpêtrière, Paris, France. Familial hypercholesterolemia (FH) is a severe condition, which…
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Cascade Screening for FH: Lessons from Brazil
How can we improve on the detection and treatment of FH? PCSK9 Forum Editor Professor Frederick Raal discusses insights from a recent study in Brazil. Familial hypercholesterolemia (FH) is the most common dominantly inherited condition in humans, affecting 1:200 to 1:500 people or over 30…
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PCSK9 plasma transport and lipoprotein association
Hagai Tavori, PhD, and Sergio Fazio, MD, PhD. Knight Cardiovascular Institute, Center of Preventive Cardiology, Oregon Health and Science University, Portland, OR. PCSK9 and LDL are ligands for the LDL receptor (LDLR). The fate of the ligand-receptor complex is dependent on the ligand, with both…
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Heterogeneity in FH: What are the implications for management?
According to Professor Frederick Raal, South Africa, irrespective of genotype, what matters is reducing the LDL-C burden with lipid-lowering therapy. Familial hypercholesterolemia (FH) is an autosomal co-dominant disorder usually resulting from mutations in the LDL receptor (LDLR) gene characterised by elevated levels of LDL-cholesterol (LDL-C)…
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