Risk stratification and imaging of preclinical atherosclerosis in familial hypercholesterolemia

Imaging of preclinical atherosclerosis forms and the identification of predictors of atherosclerotic plaque instability are key research issues in modern cardiology. To date, there are insufficient data on the morphological features of atherosclerotic plaques in patients with genetically determined lipid metabolism disorders.

Scientists at the Centre for Personalized Medicine developed and applied a protocol for examining patients with familial hypercholesterolemia with genetic testing using the most advanced screening panel and non-invasive assessment of preclinical atherosclerosis using coronary artery calcium as measured by the Agatston index (calcium index (CI)). Patients with familial hypercholesterolemia and elevated CI undergo dual-energy CT coronary angiography to study the morphology of an atherosclerotic plaque and determine predictors of its instability. Studying these characteristics will make it possible to more accurately stratify the level of cardiovascular risk in patients with familial hypercholesterolemia.

Despite the importance of accurate, timely diagnosis and management of the disease due to the fact that these patients belong to the group of high and very high cardiovascular risk, there are still questions regarding the accuracy of diagnostic protocols.

Currently, the project has compiled a unique database and analyzed these data in patients with severe clinical phenotype of familial hypercholesterolemia. The data of genetic testing combined with the Agatston index and CT coronary angiography will increase the efficiency and accuracy of the diagnosis of the disease and help predict the risk of cardiovascular complications with the possibility of using a personalized approach to managing patients with this disease.

15.10.2021