Carotid Intima-Media Thickness in Children with Familial Hypercholesterolemia
Rationale: Familial hypercholesterolemia (FH) predisposes patients to premature cardiovascular disease, with the process of atherosclerosis initiated in early childhood.
Objective: In part of an ongoing trial to assess the efficacy and safety of rosuvastatin in FH children aged 6 to 17, we report the differences in carotid intima-media thickness (cIMT) at baseline between FH children and their unaffected siblings.
Methods and Results: B-mode ultrasound measurements of the carotid artery were made in 196 children with FH and 64 of their siblings. Mean (±standard error) cIMT in children with FH was significantly greater than that of unaffected siblings (0.398 ± 0.052 mm vs. 0.377 ± 0.045 mm, P<0.001). A significantly greater cIMT value was observed before the age of 8 years. Multivariable analyses showed that age, male sex and presence of FH were independent predictors of cIMT.
Conclusions: The difference in mean cIMT between children with FH and their unaffected siblings may be significant as early as age 8 years. This study confirms the need for early cholesterol-lowering in this high risk population. These patients participating in a carefully monitored study will help assess the long-term efficacy on cIMT and safety of statin therapy in young children.
- Received March 22, 2013.
- Revision received October 22, 2013.
- Accepted October 23, 2013.