Carotid intima-media thickness correlation with lipid profile in patients with familial hypercholesterolemia versus controls.

ABSTRACT

OBJECTIVE: To determine the variations in carotid intima-media thickness (CIMT) in familial hypercholesterolemia (FH) patients and its use as predictive marker for premature cardiovascular diseases. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY National Institute of Cardiovascular Diseases and Dr. Ziauddin Hospital, Karachi, from June 2008 to October 2009. METHODOLOGY: Familial hypercholesterolemia was clinically diagnosed by premature coronary diseases, xanthomas, arcus cornealis and family history of premature coronary heart diseases. Controls were age matched normal individuals without hypercholesterolemia. Their lipid profile was tested after overnight fasting. CIMT was measured in mm using B-mode ultrasonography using linear probe. Student t-test was applied to compare mean CIMT of cases and the control. The mean CIMT values of the FH cases were correlated with LDL using Pearson's correlation test. RESULTS: Forty cases with hypercholesterolemia gave consent to participate in the study. These patients had total cholesterol ≥200 mg/dL and LDL ≥160 mg/dL as compared to twenty controls of similar age with total cholesterol ≤200 mg/dL and LDL ≤130 mg/dL. Mean CIMT for the cases was 0.77 ± 0.18 mm while mean CIMT for control was 0.59 ± 0.08 mm. The mean CIMT for the cases ranged from 0.7-1.83 mm and 0.48-0.73 mm for controls. Among the FH cases, 25% (n=11) had arterial plaques. Mean CIMT was significantly correlated to LDL-cholesterol (r = 0.725**, p < 0.001). CONCLUSION: In this study, CIMT was found to be significantly increased in familial hypercholesterolemia and it correlated with raised LDL-cholesterol. Both are predictive of premature cardiovascular diseases.