Statins and other lipid-lowering therapy and pregnancy outcomes in homozygous familial hypercholesterolaemia: A retrospective review of 39 pregnancies.
Atherosclerosis
; 277: 502-507, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-30270091
ABSTRACT
BACKGROUND AND AIMS:
Pregnancy in HoFH females is associated with further elevation of already markedly elevated low density lipoprotein cholesterol (LDL-C) levels, particularly if lipid-lowering therapy is discontinued, placing the mother and fetus at increased cardiovascular risk. Lipoprotein apheresis is the current recommended treatment for pregnant HoFH patients. However, this is costly, time consuming, and is not available in many countries. Alternative treatment strategies to control hypercholesterolaemia during pregnancy in HoFH patients are necessary.METHODS:
This study was a retrospective review of 39 pregnancies from a cohort of 20 genotypically confirmed female HoFH patients.RESULTS:
No maternal cardiac complications or deaths occurred during the pregnancies or during the first year postpartum. Twenty five pregnancies were exposed to lipid-lowering therapy, of which 18 were exposed to statin therapy, just prior to or during the pregnancy. Thirty three (84%) pregnancies carried to term, 3 (8%) premature deliveries and 3 (8%) miscarriages were observed. Complications associated with pregnancy in these HoFH patients, did not differ from those reported during pregnancies of otherwise healthy woman.CONCLUSIONS:
HoFH is a severe disease impacting significantly on life expectancy. However, for many females with HoFH, despite the high cardiovascular risk, pregnancy is not uncommon. In resource poor settings and when LA is not available, lipid lowering therapy, particularly statin therapy during pregnancy, appears to be safe for both mother and fetus and is an acceptable alternative for LDL-C reduction in these high risk patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Remoção de Componentes Sanguíneos
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Inibidores de Hidroximetilglutaril-CoA Redutases
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Hiperlipoproteinemia Tipo II
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LDL-Colesterol
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
Atherosclerosis
Ano de publicação:
2018
Tipo de documento:
Article