Advertisement

Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Prevalence of Achilles tendon xanthoma and familial hypercholesterolemia in patients with coronary artery disease undergoing percutaneous coronary intervention

Abstract

Familial hypercholesterolemia (FH) is reportedly associated with the development of coronary artery disease (CAD), especially acute coronary syndrome (ACS). However, the prevalence of FH in patients with stable CAD is still unclear. The aim of this study was to investigate the prevalence of Achilles tendon xanthoma (ATX) and heterozygous FH in patients with stable CAD and ACS undergoing percutaneous coronary intervention (PCI). A total of 423 patients with CAD (273 stable CAD and 150 ACS) undergoing PCI at Chiba University Hospital between June 2016 and February 2018 were enrolled in this study. Soft X-ray radiography of the Achilles tendon was performed in all patients, and a maximum thickness of 9 mm or more is regarded as ATX. Heterozygous FH was diagnosed according to the Japan Atherosclerosis Society Guidelines. In comparisons between stable CAD and ACS patients, ATX was observed in 9.2% vs. 15.3% (p = 0.055), and heterozygous FH was diagnosed in 3.7% vs. 5.3% (p = 0.416), respectively. Among ACS patients, those with ST elevation myocardial infarction (STEMI) showed the highest prevalence of ATX (19.5%) and FH (7.3%). Whereas ATX and heterozygous FH were considerably observed in patients with ACS, a certain number of ATX and heterozygous FH were also detected in stable CAD patients.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    Nordestgaard BG, Chapman MJ, Humphries SE, Ginsberg HN, Masana L, Descamps OS, Wiklund O, Hegele RA, Raal FJ, Defesche JC, Wiegman A, Santos RD, Watts GF, Parhofer KG, Hovingh GK, Kovanen PT, Boileau C, Averna M, Boren J, Bruckert E, Catapano AL, Kuivenhoven JA, Pajukanta P, Ray K, Stalenhoef AF, Stroes E, Taskinen MR, Tybjaerg-Hansen A (2013) Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. Eur Heart J 34:3478–3490a

  2. 2.

    Mabuchi H, Koizumi J, Shimizu M, Takeda R (1989) Development of coronary heart disease in familial hypercholesterolemia. Circulation 79:225–232

  3. 3.

    Mundal L, Sarancic M, Ose L, Iversen PO, Borgan JK, Veierod MB, Leren TP, Retterstol K (2014) Mortality among patients with familial hypercholesterolemia: a registry-based study in Norway, 1992–2010. J Am Heart Assoc 3:e001236

  4. 4.

    Krogh HW, Mundal L, Holven KB, Retterstol K (2016) Patients with familial hypercholesterolaemia are characterized by presence of cardiovascular disease at the time of death. Eur Heart J 37:1398–1405

  5. 5.

    Ohmura H, Fukushima Y, Mizuno A, Niwa K, Kobayashi Y, Ebina T, Kimura K, Ishibashi S, Daida H (2017) Estimated prevalence of heterozygous familial hypercholesterolemia in patients with acute coronary syndrome. Int Heart J 58:88–94

  6. 6.

    Inohara T, Kohsaka S, Yamaji K, Amano T, Fujii K, Oda H, Uemura S, Kadota K, Miyata H, Nakamura M (2017) Impact of institutional and operator volume on short-term outcomes of percutaneous coronary intervention: a report from the Japanese Nationwide Registry. JACC Cardiovasc Interv 10:918–927

  7. 7.

    Bujo H, Takahashi K, Saito Y, Maruyama T, Yamashita S, Matsuzawa Y, Ishibashi S, Shionoiri F, Yamada N, Kita T (2004) Clinical features of familial hypercholesterolemia in Japan in a database from 1996–1998 by the research committee of the ministry of health, labour and welfare of Japan. J Atheroscler Thromb 11:146–151

  8. 8.

    Kinoshita M, Yokote K, Arai H, Iida M, Ishigaki Y, Ishibashi S, Umemoto S, Egusa G, Ohmura H, Okamura T, Kihara S, Koba S, Saito I, Shoji T, Daida H, Tsukamoto K, Deguchi J, Dohi S, Dobashi K, Hamaguchi H, Hara M, Hiro T, Biro S, Fujioka Y, Maruyama C, Miyamoto Y, Murakami Y, Yokode M, Yoshida H, Rakugi H, Wakatsuki A, Yamashita S (2018) Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017. J Atheroscler Thromb 25:846–984

  9. 9.

    Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD (2012) Third universal definition of myocardial infarction. J Am Coll Cardiol 60:1581–1598

  10. 10.

    De Backer G, Besseling J, Chapman J, Hovingh GK, Kastelein JJ, Kotseva K, Ray K, Reiner Z, Wood D, De Bacquer D (2015) Prevalence and management of familial hypercholesterolaemia in coronary patients: an analysis of EUROASPIRE IV, a study of the European Society of Cardiology. Atherosclerosis 241:169–175

  11. 11.

    Civeira F (2004) Guidelines for the diagnosis and management of heterozygous familial hypercholesterolemia. Atherosclerosis 173:55–68

  12. 12.

    Scientific Steering Committee on behalf of the Simon Broome Register Group (1991) Risk of fatal coronary heart disease in familial hypercholesterolaemia. BMJ 303:893–896

  13. 13.

    Harada T, Inagaki-Tanimura K, Nagao M, Sato Y, Sudo M, Okajima F, Sugihara H, Oikawa S (2017) Frequency of Achilles Tendon xanthoma in patients with acute coronary syndrome. J Atheroscler Thromb 24:949–953

  14. 14.

    Rosenson RS (1993) Myocardial injury: the acute phase response and lipoprotein metabolism. J Am Coll Cardiol 22:933–940

  15. 15.

    Wattanasuwan N, Khan IA, Gowda RM, Vasavada BC, Sacchi TJ (2001) Effect of acute myocardial infarction on cholesterol ratios. Chest 120:1196–1199

  16. 16.

    Tanaka S, Ikari Y, Ijichi T, Nakazawa G (2017) Treat-to-target lipid control is effective but highlighted poor prognosis without indication of statin following percutaneous coronary intervention. Cardiovasc Interv Ther 32:358–364

Download references

Acknowledgements

This study was not funded by any organizations or sponsors.

Author information

Correspondence to Hideki Kitahara.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kitahara, H., Mori, N., Saito, Y. et al. Prevalence of Achilles tendon xanthoma and familial hypercholesterolemia in patients with coronary artery disease undergoing percutaneous coronary intervention. Heart Vessels 34, 1595–1599 (2019). https://doi.org/10.1007/s00380-019-01400-6

Download citation

Keywords

  • Coronary artery disease
  • Familial hypercholesterolemia
  • Achilles tendon xanthoma