机构：[1]School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia[2]Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR[3]Biochemistry and Pathology, Canterbury Health Laboratories, Lipid Clinic, Christchurch Hospital, University of Otago, Christchurch, New Zealand[4]University of Manchester, Faculty of Biology, Medicine and Health, Manchester, United Kingdom[5]Cardiovascular Trials Unit, Clinical Trial Management Office, Manchester Royal Infirmary, Manchester, United Kingdom[6]Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan[7]Faculty of Medicine, School of Medicine, National Yang–Ming University, Taipei, Taiwan[8]Department of Atherosclerosis, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China临床科室动脉硬化门诊首都医科大学附属安贞医院[9]Department of Cardiology, Hanoi Medical University, Hanoi, Vietnam[10]Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam[11]Division of Chemical Pathology, University of Cape Town Health Science Faculty, South Africa[12]Institute of Pathology, Laboratory and Forensic Medicine (I–PPerForM), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia[13]Department of Cardiology, Section of Preventive Cardiology, UP–Philippine General Hospital, Manila, Philippines[14]Departments of Environmental and Occupational Medicine, Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan[15]Lipid Clinic Heart Institute (InCor), University of S~ao Paulo Medical School Hospital and Hospital Israelita Albert Einstein, S~ao Paulo, Brazil[16]Departments of Cardiovascular Medicine and Community Medicine, Osaka University Graduate School of Medicine, Osaka, Japan[17]Rinku General Medical Center, Osaka, Japan[18]School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia[19]Department of Cardiology, Lipid Disorders Clinic, Cardiometabolic Services, Royal Perth Hospital, Perth, Western Australia, Australia
BACKGROUND: There is a lack of information on the health care of familial hypercholesterolemia (FH). OBJECTIVE: The objective of this study was to compare the health care of FH in countries of the Asia-Pacific region and Southern Hemisphere. METHODS: A series of questionnaires were completed by key opinion leaders from selected specialist centers in 12 countries concerning aspects of the care of FH, including screening, diagnosis, risk assessment, treatment, teaching/training, and research; the United Kingdom (UK) was used as the international benchmark. RESULTS: The estimated percentage of patients diagnosed with the condition was low (overall <3%) in all countries, compared with similar to 15% in the UK. Underdetection of FH was associated with government expenditure on health care (x = 0.667, P<.05). Opportunistic and systematic screening methods, and the Dutch Lipid Clinic Network criteria were most commonly used to detect FH; genetic testing was infrequently used. Noninvasive imaging of coronary calcium and/or carotid plaques was underutilized in risk assessment. Patients with FH were generally not adequately treated, with <30% of patients achieving guideline recommended low-density lipoprotein cholesterol targets on conventional therapies. Treatment gaps included suboptimal availability and use of lipoprotein apheresis and proprotein convertase subtilsin-kexin type 9 inhibitors. A deficit of FH registries, training programs, and publications were identified in less economically developed countries. The demonstration of cost-effectiveness for cascade screening, genetic testing, and specialized treatments were significantly associated with the availability of subsidies from the health care system (x = 0.571-0.800, P<.05). CONCLUSION: We identified important gaps across the continuum of care for FH, particularly in less economically developed countries. Wider implementation of primary and pediatric care, telehealth services, patient support groups, education/training programs, research activities, and health technology assessments are needed to improve the care of patients with FH in these countries. (C) 2019 National Lipid Association. All rights reserved.
基金：
International Atherosclerosis Society; Pfizer Independent Grants for Learning Change [10839501]
第一作者机构：[1]School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
通讯作者：
通讯机构：[1]School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia[19]Department of Cardiology, Lipid Disorders Clinic, Cardiometabolic Services, Royal Perth Hospital, Perth, Western Australia, Australia[*1]Department of Cardiology, Lipid Disorders Clinic, Royal Perth Hospital, GPO Box X2213, Perth, WA 6847, Australia.
推荐引用方式(GB/T 7714)：
Jing Pang,Dick C. Chan,Miao Hu,et al.Comparative aspects of the care of familial hypercholesterolemia in the "Ten Countries Study"[J].JOURNAL OF CLINICAL LIPIDOLOGY.2019,13(2):287-300.doi:10.1016/j.jacl.2019.01.009.
APA：
Jing Pang,Dick C. Chan,Miao Hu,Lauretta A. Muir,See Kwok...&Gerald F. Watts.(2019).Comparative aspects of the care of familial hypercholesterolemia in the "Ten Countries Study".JOURNAL OF CLINICAL LIPIDOLOGY,13,(2)
MLA：
Jing Pang,et al."Comparative aspects of the care of familial hypercholesterolemia in the "Ten Countries Study"".JOURNAL OF CLINICAL LIPIDOLOGY 13..2(2019):287-300
医学