Familial hypercholesterolemia in the Czech Republic in 2016

Czech version

Authors: Tomáš Freiberger ¹; Martina Vaclová ²; Lukáš Tichý ³; Vladimír Soška ^4,5,6; Vladimír Bláha ⁷; Lenka Fajkusová ³; Richard Češka ²; Michal Vrablík ²
Authors‘ workplace: Genetická laboratoř Centra kardiovaskulární a transplantační chirurgie, Brno ¹; III. interní klinika 1. LF UK a VFN v Praze ²; Centrum molekulární biologie a genové terapie FN Brno ³; Oddělení klinické biochemie a ICRC – oddělení kardiovaskulárních chorob, FN u sv. Anny v Brně ⁴; Katedra laboratorních metod, LF MU Brno ⁵; II. interní klinika LF MU a FN U sv. Anny v Brně ⁶; III. interní gerontometabolická klinika LF UK a FN Hradec Králové ⁷
Published in: Vnitř Lék 2016; 62(11): 924-928
Category: Reviews

Overview

Familial hypercholesterolemia (FH) is the most frequent autosomal dominant hereditary disease which is characterized by a decreased LDL-cholesterol catabolism and early clinical manifestation of atherosclerosis affecting blood vessels. The MedPed (Make early diagnosis to Prevent early deaths) project aims to diagnose patients with FH as early as possible, so that they can profit the most from a therapy started in a timely manner and avoid premature cardiovascular events. Currently, as of 31 October 2016, the Czech national database keeps records of 6 947 patients with FH from 5 223 families. Considering the prevalence of FH equalling 1 : 250, this represents 17.4 % of the overall expected number of patients with FH in the Czech Republic. Determining the mutation responsible for FH, now using a next generation sequencing technology in the Czech Republic, brings with it higher diagnostic accuracy, better cooperation of patients and in particular facilitation of cascade screening in families. Although we are among the most successful countries in the world with regard to FH detection, the majority of patients are still undiagnosed. Moreover, as it turns out, most FH patients do not reach the target values with the current therapeutic possibilities. In this regard the newly approved hypolipidemic drugs, PCSK9 inhibitors, to be hopefully available also in the Czech Republic in the near future for chosen patients with FH at high risk, hold great promise.

Key words:
cascade screening – familial hypercholesterolemia – LDL-cholesterol – MedPed

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