Opportunistic Genetic Testing for Familial Hypercholesterolemia in Premature Acute Coronary Syndrome

doi:10.1016/j.jacadv.2026.103053

Coronary disease & ACSCohort study

Opportunistic Genetic Testing for Familial Hypercholesterolemia in Premature Acute Coronary Syndrome

JACC AdvPublished 7 Aug 2026

nonrandomized, prospective study
2 sequential cohorts

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Authors' conclusion

Opportunistic genetic testing of young adults with ACS was associated with increased FH diagnosis, more intensive lipid-lowering treatment, and improved lipid target attainment. (Advancing Cardiac Care Unit-based Rapid Assessment and Treatment of hypErcholesterolemia [ACCURATE]; NCT05218005).

Study context

Population: Patients <60 years old admitted with acute coronary syndrome (ACS) and low-density lipoprotein cholesterol (LDL-C) ≥4 mmol/L (≥155 mg/dL)completed the study · phase 1 40 · phase 2 100
Participants: 40 vs 100

Exposure: phase 1 vs phase 2
phase 1n = 40
phase 2n = 100
Outcome: New diagnosis of definite FH
Follow-up: 15 months post-ACS

Main finding

As reported in the abstract

phase 210%

phase 10%

Observational data: associations, not effects.

Secondary outcomes

LDL-C <1.8 mmol/L · 15 months · more likely with phase 2

P = 0.04

phase 153%

phase 273%

Receiving statin therapy · 15 months · more likely with phase 2

P = 0.04

phase 183%

phase 295%

Receiving statin-ezetimibe combination therapy · 15 months · more likely with phase 2

P = 0.02

phase 130%

phase 252%

Mean LDL-C · 15 months · lower with phase 2

P = 0.03

phase 1mean 1.93 mmol/L

phase 2mean 1.65 mmol/L

mg/dL phase 1 75 mg/dL · phase 2 64 mg/dL

Original publication

Opportunistic Genetic Testing for Familial Hypercholesterolemia in Premature Acute Coronary Syndrome. JACC Adv. Published 7 August 2026. doi:10.1016/j.jacadv.2026.103053

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Summarised from the published abstract; every number is checked against it