Prevention & lipidsCohort study
Sex Differences in Diagnosis, Treatment, and Cardiovascular Outcomes in Homozygous Familial Hypercholesterolemia
- Retrospective cohort study
- international registry (HoFH International Clinical Collaborators (HICC))
- 88 institutions, 38 countries
- sex-specific analyses
Data entry February 2016 to December 2020; analysed June 2022 to June 2023
Authors' conclusion
In this cohort study of individuals with known HoFH, MI was higher in men compared with women yet age at diagnosis and at first ASCVD event were similar.
Study context
- Population
- Patients with homozygous familial hypercholesterolemia (HoFH) alive during or after 2010, HICC registry
- Participants
- 389 vs 362
- Exposure
- Women vs men with HoFH
- Womenn = 389
- Menn = 362reference
- Outcome
- Sex differences in age at diagnosis, risk factors, lipid-lowering treatment, and atherosclerotic cardiovascular disease (ASCVD) morbidity (MI, aortic stenosis, combined ASCVD outcomes) and mortality
Main finding
As reported in the abstract
Women vs MenEstimate (95% CI)
cumulative incidence of MI 16 years after diagnosis: 5.0% vs 13.7%
SHR 0.37(0.21–0.66)
all-cause mortality 16 years after diagnosis: 3.0% vs 4.1%
HR 0.76(0.40–1.45)
CV mortality 16 years after diagnosis: 2.6% vs 4.1%
SHR 0.87(0.44–1.75)
Observational data: associations, not effects.
Further findings
| Outcome | Women | Men |
|---|---|---|
| Lipid-lowering therapy | ||
| Statins | 248 of 276 [89.9%] | 235 of 258 [91.1%] |
| Lipoprotein apheresis | 115 of 317 [36.3%] | 118 of 304 [38.8%] |
Lipid-lowering therapy
- Treated low-density lipoprotein (LDL) cholesterol levels and lipid-lowering therapy similar in both sexes
Original publication
Sex Differences in Diagnosis, Treatment, and Cardiovascular Outcomes in Homozygous Familial Hypercholesterolemia. JAMA Cardiol. Published 1 April 2024. doi:10.1001/jamacardio.2023.5597
Summarised from the published abstract; every number is checked against it