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Reporting LDL cholesterol results by clinical biochemistry laboratories in Czechia and Slovakia to improve the detection rate of familial hypercholesterolemia

. 2023 Oct 15 ; 33 (3) : 030705.

Language English Country Croatia Media print

Document type Journal Article

INTRODUCTION: This survey aims to assess the implementation of recommendations from the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) by clinical biochemistry laboratories in Czechia and Slovakia in their policies for reporting low-density lipoprotein cholesterol (LDL-C) concentrations. MATERIALS AND METHODS: The web-based survey was distributed to all 383 Czech and Slovak clinical biochemistry laboratories that measure lipids by external quality assessment provider SEKK. A total of 17 single-answer questions were included. The questionnaire was focused on the detection and decision points in familial hypercholesterolemia (FH). All survey answers were taken into account. The laboratories followed the EFLM and EAS guidelines when they reported an interpretative comment considering FH diagnosis in adults. RESULTS: A total of 203 (53%) laboratories answered. Only 5% of laboratories added interpretative comments considering FH diagnosis when LDL-C concentrations are above 5.0 mmol/L in adults, and 3% of laboratories added interpretative comments considering FH diagnosis when LDL-C concentrations are above 4.0 mmol/L in children. Only 7% of laboratories reported goals for all cardiovascular risk categories (low, moderate, high, very high). Non-HDL cholesterol concentrations were calculated by 74% of responders. A significant number (51%) of participants did not measure apolipoprotein B, and 59% of laboratories did not measure lipoprotein(a). CONCLUSIONS: Only a small portion of laboratories from Czechia and Slovakia reported high LDL-C results with interpretative comments considering FH diagnosis in adults, the laboratories did not follow the guidelines.

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Beheshti SO, Madsen CM, Varbo A, Nordestgaard BG. Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. J Am Coll Cardiol. 2020;75:2553–66. 10.1016/j.jacc.2020.03.057 PubMed DOI

Santos RD, Gidding SS, Hegele RA, Cuchel MA, Barter PJ, Watts GF, et al. Defining severe familial hypercholesterolaemia and the implications for clinical management: a consensus statement from the International Atherosclerosis Society Severe Familial Hypercholesterolemia Panel. Lancet Diabetes Endocrinol. 2016;4:850–61. 10.1016/S2213-8587(16)30041-9 PubMed DOI

Zubielienė K, Valterytė G, Jonaitienė N, Žaliaduonytė D, Zabiela V. Familial Hypercholesterolemia and Its Current Diagnostics and Treatment Possibilities: A Literature Analysis. Medicina (Kaunas). 2022;58:1665. 10.3390/medicina58111665 PubMed DOI PMC

Vrablík M, Vaclová M, Tichý L, Soška V, Bláha V, Fajkusová L, et al. Familial hypercholesterolemia in the Czech Republic: more than 17 years of systematic screening within the MedPed project. Physiol Res. 2017;66:S1–9. 10.33549/physiolres.933600 PubMed DOI

Ceska R, Latkovskis G, Ezhov MV, Freiberger T, Lalic K, Mitchenko O, et al. The Impact of the International Cooperation On Familial Hypercholesterolemia Screening and Treatment: Results from the ScreenPro FH Project. Curr Atheroscler Rep. 2019;21:36. 10.1007/s11883-019-0797-3 PubMed DOI PMC

EAS Familial Hypercholesterolaemia Studies Collaboration. Vallejo-Vaz AJ, De Marco M, Stevens CAT, Akram A, Freiberger T, Hovingh GK, et al. . Overview of the current status of familial hypercholesterolaemia care in over 60 countries - The EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC). Atherosclerosis. 2018;277:234–55. 10.1016/j.atherosclerosis.2018.08.051 PubMed DOI

Fath F, Bengeser A, Barresi M, Binner P, Schwab S, Ray KK, et al. FH ALERT: efficacy of a novel approach to identify patients with familial hypercholesterolemia. Sci Rep. 2021;11:20421. 10.1038/s41598-021-99961-y PubMed DOI PMC

Langlois MR, Nordestgaard BG, Langsted A, Chapman MJ, Aakre KM, Baum H, et al. Quantifying atherogenic lipoproteins for lipid-lowering strategies: consensus-based recommendations from EAS and EFLM. Clin Chem Lab Med. 2020;58:496–517. 10.1515/cclm-2019-1253 PubMed DOI

Hopkins PN, Toth PP, Ballantyne CM, Rader DJ. Familial hypercholesterolemias: Prevalence, genetics, diagnosis and screening recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol. 2011;5:S9–17. 10.1016/j.jacl.2011.03.452 PubMed DOI

Bedlington N, Abifadel M, Beger B, Bourbon M, Bueno H, Ceska R, et al. The time is now: Achieving FH paediatric screening across Europe – The Prague Declaration. GMS Health Innov Technol. 2022;16:04. PubMed PMC

SEKK. Available from: https://sekk.cz/index_1.htm. Accessed July 11th 2023.

De Wolf HA, Langlois MR, Suvisaari J, Aakre KM, Baum H, Collinson P, et al. How well do laboratories adhere to recommended guidelines for dyslipidaemia management in Europe? The CArdiac MARker Guideline Uptake in Europe (CAMARGUE) study. Clin Chim Acta. 2020;508:267–72. 10.1016/j.cca.2020.05.038 PubMed DOI

da Silva PM, Duarte JS, von Hafe P, Gil V, de Oliveira JN, de Sousa G. Standardization of laboratory and lipid profile evaluation: A call for action with a special focus in 2016 ESC/EAS dyslipidaemia guidelines - Full report. Atheroscler Suppl. 2018;31:e1–12. 10.1016/j.atherosclerosissup.2018.04.001 PubMed DOI

Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2021;42:3227–337. 10.1093/eurheartj/ehab484 PubMed DOI

Giugliano RP, Pedersen TR, Park JG, De Ferrari GM, Gaciong ZA, Ceska R, et al. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. Lancet. 2017;390:1962–71. 10.1016/S0140-6736(17)32290-0 PubMed DOI

Khan SU, Michos ED. Cardiovascular mortality after intensive LDL-Cholesterol lowering: Does baseline LDL-Cholesterol really matter? Am J Prev Cardiol. 2020;1:100013. 10.1016/j.ajpc.2020.100013 PubMed DOI PMC

Bandyopadhyay D, Qureshi A, Ghosh S, Ashish K, Heise LR, Hajra A, et al. Safety and Efficacy of Extremely Low LDL-Cholesterol Levels and Its Prospects in Hyperlipidemia Management. J Lipids. 2018;2018:8598054. 10.1155/2018/8598054 PubMed DOI PMC

Karagiannis AD, Mehta A, Dhindsa DS, Virani SS, Orringer CE, Blumenthal RS, et al. How low is safe? The frontier of very low (<30 mg/dL) LDL cholesterol. Eur Heart J. 2021;42:2154–69. 10.1093/eurheartj/ehaa1080 PubMed DOI

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502. 10.1093/clinchem/18.6.499 PubMed DOI

Solnica B, Sygitowicz G, Sitkiewicz D, Cybulska B, Jóźwiak J, Odrowąż-Sypniewska G, et al. 2020 Guidelines of the Polish Society of Laboratory Diagnostics (PSLD) and the Polish Lipid Association (PoLA) on laboratory diagnostics of lipid metabolism disorders. Arch Med Sci AMS. 2020;16:237–52. 10.5114/aoms.2020.93253 PubMed DOI PMC

Martin SS, Blaha MJ, Elshazly MB, Toth PP, Kwiterovich PO, Blumenthal RS, et al. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA. 2013;310:2061–8. 10.1001/jama.2013.280532 PubMed DOI PMC

Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e1082–143. 10.1161/CIR.0000000000000624 PubMed DOI PMC

Langlois MR, Descamps OS, van der Laarse A, Weykamp C, Baum H, Pulkki K, et al. Clinical impact of direct HDLc and LDLc method bias in hypertriglyceridemia. A simulation study of the EAS-EFLM Collaborative Project Group. Atherosclerosis. 2014;233:83–90. 10.1016/j.atherosclerosis.2013.12.016 PubMed DOI

Miida T, Nishimura K, Okamura T, Hirayama S, Ohmura H, Yoshida H, et al. A multicenter study on the precision and accuracy of homogeneous assays for LDL-cholesterol: comparison with a beta-quantification method using fresh serum obtained from non-diseased and diseased subjects. Atherosclerosis. 2012;225:208–15. 10.1016/j.atherosclerosis.2012.08.022 PubMed DOI

SCORE2 working group and ESC Cardiovascular risk collaboration . SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42:2439–54. 10.1093/eurheartj/ehab309 PubMed DOI PMC

Johannesen CDL, Mortensen MB, Langsted A, Nordestgaard BG. Apolipoprotein B and Non-HDL Cholesterol Better Reflect Residual Risk Than LDL Cholesterol in Statin-Treated Patients. J Am Coll Cardiol. 2021;77:1439–50. 10.1016/j.jacc.2021.01.027 PubMed DOI

Burgess S, Ference BA, Staley JR, Freitag DF, Mason AM, Nielsen SF, et al. Association of LPA Variants With Risk of Coronary Disease and the Implications for Lipoprotein(a)-Lowering Therapies: A Mendelian Randomization Analysis. JAMA Cardiol. 2018;3:619–27. 10.1001/jamacardio.2018.1470 PubMed DOI PMC

Marcovina SM, Albers JJ. Lipoprotein (a) measurements for clinical application. J Lipid Res. 2016;57:526–37. 10.1194/jlr.R061648 PubMed DOI PMC

Šálek T, Soška V, Budina M, Vecka M, Šálková V, Vrablík M. Reportování výsledků krevních lipidů, je nutné myslet na familiární hypercholesterolémii. Fons. 2023;1:15. [In Czech]

Soška V, Franeková J, Friedecký B, Jabor A, Krampl P, Rosolová H, et al. Společné stanovisko českých odborných společností ke konsensu European Atherosclerosis Society a European Federation of Clinical Chemistry and Laboratory Medicine k vyšetřování krevních lipidů a k interpretaci jejich hodnot. Klin Biochem Metab. 2017;46:36–42. [In Czech] PubMed

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