Prevention & lipidsCohort study
Cascade screening in familial hypercholesterolaemia is associated with earlier statin initiation and fewer cardiovascular events than opportunistic screening
- Retrospective cohort study
- registry-based
- age- and sex-matched subpopulation analysis
Authors' conclusion
The cascade screening strategy for familial hypercholesterolaemia is associated with 51% fewer cardiovascular events in genetically confirmed heFH probably due to an earlier age at treatment initiation.
Study context
- Population
- Patients with molecularly diagnosed heterozygous familial hypercholesterolaemia, French FH registry REFERCHOL
- Participants
- 3,232 patients
- Exposure
- Cascade screening vs opportunistic screening for heterozygous familial hypercholesterolaemia (HeFH)
- Cascade screening casesn = 1,126
- Index casesn = 2,106reference
- Outcome
- Cardiovascular events (ASCVD)
Main finding
As reported in the abstract
ASCVD
- Cascade screening independently associated with 51% less atherosclerotic cardiovascular disease (ASCVD) than opportunistic screening (multivariate logistic regression)
Observational data: associations, not effects.
Further findings
CV event prior to first visit
P < 0.001
Age at statin initiation · statin started earlier
difference 14 · P < 0.001
ASCVD in age- and sex-matched analysis
- Cascade screening no longer associated with ASCVD; age at statin initiation remained associated
- age- and sex-matched analysis
Age at statin initiation and ASCVD
- Higher adjusted OR for ASCVD with higher age categories at statin initiation
Original publication
Cascade screening in familial hypercholesterolaemia is associated with earlier statin initiation and fewer cardiovascular events than opportunistic screening. Eur J Prev Cardiol. Published 6 May 2025. doi:10.1093/eurjpc/zwaf234
Summarised from the published abstract; every number is checked against it