Physicians' Academy for Cardiovascular Education

Statin treatment slows progression of carotid atherosclerosis in children with heterozygous FH

Effect of Rosuvastatin on Carotid Intima-Media Thickness in Children with Heterozygous Familial Hypercholesterolemia: The CHARON Study

Braamskamp MJAM, Langslet G, McCrindle BW, et al. - Circulation 2017; published online ahead of print

Background

Children with heterozygous familial hypercholesterolemia (HeFH) have endothelial dysfunction and increased carotid intima-media thickness (IMT) [1-3]. Current pediatric guidelines recommend initiation of statin therapy from 8 years onwards with the aim to achieve an LDL-C <3.5 mmol/L (130 mg/dL), in order to prevent accelerated premature atherosclerosis [4,5]. The efficacy and safety of rosuvastatin has been tested recently in HeFH children and adolescents between the ages of 6 and 17 years [6,7].

In this analysis, the effect of robust LDL-C reduction with rosuvastatin for 2 years on carotid IMT was assessed in HeFH children, compared with unaffected and untreated siblings.

Main results

Conclusion

Children with HeFH treated with rosuvastatin had a slower progression of carotid atherosclerosis measured by carotid IMT, diminishing the difference in IMT between them and unaffected siblings.

The rate of progression in carotid IMT was actually less in the HeFH subjects compared with unaffected siblings. This may indicate that more effective therapy also contributes to removal of previously accumulated lipid in the arterial wall; however, further studies are needed to confirm this.

These findings support the value of early initiation of aggressive LDL-C reduction in these patients, for the reduction of their CV risk.

References

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Find this article online at Circulation