<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Familial hypercholesterolemia (FH) is a genetic disorder that affects about 1 in 250 people and increases the likelihood of having coronary heart disease at a younger age. We present the case of a 55-year-old patient, known with inferior and anterior myocardial infarction treated by percutaneous coronary intervention and coronary artery bypass grafts, Leriche syndrome, aortic abdominal aneurysm, and bilateral renal stents—pathologies with onset at a young age—who was admitted for fast-paced palpitations, accompanied by increased fatigue. The coronarography did not reveal any acute lesions, but the presence of ventricular tachycardia at admission required the implantation of a cardiac defibrillator. Since the patient presented with early onset severe systemic atherosclerosis, with a lipid profile dominated by hypo-HDL, doubled by an apolipoprotein A1 deficiency, we considered the diagnosis of familial hypercholesterolemia. Due to the high-risk profile, the association between a statin and a PCSK9 inhibitor was initiated at discharge. At the 1-month follow-up control, a significant reduction of LDL-C has been achieved, with a simultaneous increase of HDL-C serum levels.</p>
</abstract>

Familial hypercholesterolemia (FH) is a genetic disorder that affects about 1 in 250 people and increases the likelihood of having coronary heart disease at a younger age. We present the case of a 55-year-old patient, known with inferior and anterior myocardial infarction treated by percutaneous coronary intervention and coronary artery bypass grafts, Leriche syndrome, aortic abdominal aneurysm, and bilateral renal stents—pathologies with onset at a young age—who was admitted for fast-paced palpitations, accompanied by increased fatigue. The coronarography did not reveal any acute lesions, but the presence of ventricular tachycardia at admission required the implantation of a cardiac defibrillator. Since the patient presented with early onset severe systemic atherosclerosis, with a lipid profile dominated by hypo-HDL, doubled by an apolipoprotein A1 deficiency, we considered the diagnosis of familial hypercholesterolemia. Due to the high-risk profile, the association between a statin and a PCSK9 inhibitor was initiated at discharge. At the 1-month follow-up control, a significant reduction of LDL-C has been achieved, with a simultaneous increase of HDL-C serum levels.

Young Age Onset Multivascular Pathology in a Patient with Severe Dyslipidemia: an Incidental Case or a Particular Type of Familial Hypercholesterolemia?

Grigore T. Popa University of Medicine and Pharmacy

Romanian Journal of Cardiology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Familial hypercholesterolemia (FH) is a genetic disorder that affects about 1 in 250 people and increases the likelihood of having coronary heart disease at a...

Parameter	Atorvastatin	Atorvastatin 20 mg + Alirocumab 150 mg	4 weeks after association of treatment
Total Cholesterol	226 mg/dl	110 mg/dl	−52%
LDL-C	178 mg/dl	58 mg/dl	−68%
HDL-C	28 mg/dl	39 mg/dl	+40%
Triglycerides	104 mg/dl	81 mg/dl	−22%

Young Age Onset Multivascular Pathology in a Patient with Severe Dyslipidemia: an Incidental Case or a Particular Type of Familial Hypercholesterolemia?

Article Category: Case Report

Published Online: Aug 27, 2022

Page range: 160 - 164

DOI: https://doi.org/10.2478/rjc-2022-0012

Keywords
familial hypercholesterolemia, dyslipidemia, coronary syndrome, PCSK9 inhibitor, apolipoprotein A1, multivascular disease

© 2022 Radu-Stefan Miftode et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Figure 2

Figure 3

Figure 4

The dynamics of lipid profile modifications under the association of statin and PCSK9 inhibitor (comparison between the levels of the lipid profile during hospitalisation and at 1 month follow-up)

Young Age Onset Multivascular Pathology in a Patient with Severe Dyslipidemia: an Incidental Case or a Particular Type of Familial Hypercholesterolemia?

Article Category: Case Report

Published Online: Aug 27, 2022

Page range: 160 - 164

DOI: https://doi.org/10.2478/rjc-2022-0012

Keywordsfamilial hypercholesterolemia, dyslipidemia, coronary syndrome, PCSK9 inhibitor, apolipoprotein A1, multivascular disease

© 2022 Radu-Stefan Miftode et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Figure 2

Figure 3

Figure 4

The dynamics of lipid profile modifications under the association of statin and PCSK9 inhibitor (comparison between the levels of the lipid profile during hospitalisation and at 1 month follow-up)

Keywords
familial hypercholesterolemia, dyslipidemia, coronary syndrome, PCSK9 inhibitor, apolipoprotein A1, multivascular disease