open access

Vol 12, Supp. B (2017)
Praca na konkurs pt. "Terapia skojarzona"
Published online: 2018-03-04
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A 61-year-old woman with coronary artery disease, familial hypercholesterolemia and metabolic syndrome — the role of compliance

Anna Kowalczys, Agnieszka Mickiewicz, Marcin Gruchała
DOI: 10.5603/FC.2017.0043

open access

Vol 12, Supp. B (2017)
Praca na konkurs pt. "Terapia skojarzona"
Published online: 2018-03-04

Abstract

A 61-year-old woman with a history of severe, uncontrolled arterial hypertension, coronary artery disease, heterozygous familial hypercholesterolemia (FH), metabolic syndrome and numerous comorbidities, after many percutaneous coronary interventions (PCI) and vascular interventions was admitted to the hospital due to exacerbation of angina. Coronary angiography revealed hemodynamically significant stenosis in the circumflex branch and artery angioplasty with drug eluting stent (DES) was successfully performed. Laboratory tests revealed still significantly elevated levels of LDL cholesterol. The patient was previously treated with LDL apheresis which has been interrupted due to a history of ischemic strokes complicated by hemiparesis and aphasia. Pharmacological treatment has been modified, control visit and resuming LDL-apheresis or PCSK-9 therapy consideration prescribed. After obtaining the improvement of compliance good control of blood pressure was confirmed. The presented case provide the possibility of using different therapeutic strategies in patients with familial hypercholesterolemia and underlines the key role of compliance in the control of risk factors for cardiovascular diseases, particularly hypertension.

Abstract

A 61-year-old woman with a history of severe, uncontrolled arterial hypertension, coronary artery disease, heterozygous familial hypercholesterolemia (FH), metabolic syndrome and numerous comorbidities, after many percutaneous coronary interventions (PCI) and vascular interventions was admitted to the hospital due to exacerbation of angina. Coronary angiography revealed hemodynamically significant stenosis in the circumflex branch and artery angioplasty with drug eluting stent (DES) was successfully performed. Laboratory tests revealed still significantly elevated levels of LDL cholesterol. The patient was previously treated with LDL apheresis which has been interrupted due to a history of ischemic strokes complicated by hemiparesis and aphasia. Pharmacological treatment has been modified, control visit and resuming LDL-apheresis or PCSK-9 therapy consideration prescribed. After obtaining the improvement of compliance good control of blood pressure was confirmed. The presented case provide the possibility of using different therapeutic strategies in patients with familial hypercholesterolemia and underlines the key role of compliance in the control of risk factors for cardiovascular diseases, particularly hypertension.
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Keywords

coronary artery disease, familial hypercholesterolemia, metabolic syndrome, hypertension, compliance

About this article
Title

A 61-year-old woman with coronary artery disease, familial hypercholesterolemia and metabolic syndrome — the role of compliance

Journal

Folia Cardiologica

Issue

Vol 12, Supp. B (2017)

Pages

13-17

Published online

2018-03-04

DOI

10.5603/FC.2017.0043

Keywords

coronary artery disease
familial hypercholesterolemia
metabolic syndrome
hypertension
compliance

Authors

Anna Kowalczys
Agnieszka Mickiewicz
Marcin Gruchała

References (4)
  1. Zdrojewski T, Bandosz P, Rutkowski M, et al. Rozpowszechnienie, wykrywanie i skuteczność leczenia nadciśnienia tętniczego w Polsce-wyniki badania NATPOL 2011. Nadciśnienie Tętnicze. 2014; 18(2): 116–117.
  2. Catapano AL, Graham I, Backer GDe, et al. [2016 ESC/EAS Guidelines for the Management of Dyslipidaemias]. Kardiol Pol. 2016; 74(11): 1234–1318.
  3. Mabuchi H, Koizumi J, Shimizu M, et al. Long-term efficacy of low-density lipoprotein apheresis on coronary heart disease in familial hypercholesterolemia. Am J Cardiol. 1998; 82(12): 1489–1495.
  4. Jacobson TA, Ito MK, Maki KC, et al. National lipid association recommendations for patient-centered management of dyslipidemia: part 1--full report. J Clin Lipidol. 2015; 9(2): 129–169.

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