Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia
Background: Achilles tendon thickening (ATT) can be ameliorated by lowering low-density lipoprotein (LDL) levels in patients with familial hypercholesterolemia (FH). The Japan Atherosclerosis Society (JAS) defines ATT as ≥8.0 mm in males and ≥7.5 mm in females. We aimed to determine the clinical imp...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-06-01
|
| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266666772400028X |
| _version_ | 1797235451862450176 |
|---|---|
| author | Hayato Tada Nobuko Kojima Yasuaki Takeji Atsushi Nohara Masa-aki Kawashiri Masayuki Takamura |
| author_facet | Hayato Tada Nobuko Kojima Yasuaki Takeji Atsushi Nohara Masa-aki Kawashiri Masayuki Takamura |
| author_sort | Hayato Tada |
| collection | DOAJ |
| description | Background: Achilles tendon thickening (ATT) can be ameliorated by lowering low-density lipoprotein (LDL) levels in patients with familial hypercholesterolemia (FH). The Japan Atherosclerosis Society (JAS) defines ATT as ≥8.0 mm in males and ≥7.5 mm in females. We aimed to determine the clinical impact of changes in ATT on the development of major adverse cardiovascular events (MACE). Methods: Patients with clinically diagnosed heterozygous FH (HeFH) (N = 1273; 614 males, 659 females) with ATT data from X-ray were assessed. Patients were divided into four groups: patients without ATT from baseline until follow-up (group 1), patients without ATT at baseline but developed ATT at follow-up (group 2), patients with ATT at baseline but regressed at follow-up (group 3), and patients with ATT from baseline until follow-up (group 4). Cox proportional hazard models were used to assess the factors associated with MACE, including cardiovascular death and any coronary events. Results: On follow-up (median: 10.9 years), 142 MACEs were observed, and the median ATT regressed from 7.8 to 7.6 mm. Changes in ATT were significantly associated with the occurrence of MACE in all groups, when compared to group 1 (hazard ratio [HR]: 2.73; 95 % confidence interval [CI]: 1.33–4.13 [p < 0.001], HR: 2.18, 95 % CI: 1.08–3.28, [p < 0.001], HR: 6.34, 95 % CI: 3.10–9.58, [p < 0.001], in groups 2, 3, and 4, respectively). Conclusions: Assessing ATT has diagnostic value and allows for risk stratification among patients with HeFH. |
| first_indexed | 2024-04-24T16:48:10Z |
| format | Article |
| id | doaj.art-2a52166894b24ff89080ce8569d75c1d |
| institution | Directory Open Access Journal |
| issn | 2666-6677 |
| language | English |
| last_indexed | 2024-04-24T16:48:10Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj.art-2a52166894b24ff89080ce8569d75c1d2024-03-29T05:51:15ZengElsevierAmerican Journal of Preventive Cardiology2666-66772024-06-0118100660Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemiaHayato Tada0Nobuko Kojima1Yasuaki Takeji2Atsushi Nohara3Masa-aki Kawashiri4Masayuki Takamura5Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan; Corresponding author at: Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa 920-8641, Japan.Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, JapanDepartment of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, JapanDepartment of Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, JapanDepartment of Internal Medicine, Kaga Medical Center, JapanDepartment of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, JapanBackground: Achilles tendon thickening (ATT) can be ameliorated by lowering low-density lipoprotein (LDL) levels in patients with familial hypercholesterolemia (FH). The Japan Atherosclerosis Society (JAS) defines ATT as ≥8.0 mm in males and ≥7.5 mm in females. We aimed to determine the clinical impact of changes in ATT on the development of major adverse cardiovascular events (MACE). Methods: Patients with clinically diagnosed heterozygous FH (HeFH) (N = 1273; 614 males, 659 females) with ATT data from X-ray were assessed. Patients were divided into four groups: patients without ATT from baseline until follow-up (group 1), patients without ATT at baseline but developed ATT at follow-up (group 2), patients with ATT at baseline but regressed at follow-up (group 3), and patients with ATT from baseline until follow-up (group 4). Cox proportional hazard models were used to assess the factors associated with MACE, including cardiovascular death and any coronary events. Results: On follow-up (median: 10.9 years), 142 MACEs were observed, and the median ATT regressed from 7.8 to 7.6 mm. Changes in ATT were significantly associated with the occurrence of MACE in all groups, when compared to group 1 (hazard ratio [HR]: 2.73; 95 % confidence interval [CI]: 1.33–4.13 [p < 0.001], HR: 2.18, 95 % CI: 1.08–3.28, [p < 0.001], HR: 6.34, 95 % CI: 3.10–9.58, [p < 0.001], in groups 2, 3, and 4, respectively). Conclusions: Assessing ATT has diagnostic value and allows for risk stratification among patients with HeFH.http://www.sciencedirect.com/science/article/pii/S266666772400028XFamilial hypercholesterolemiaAchilles tendon thicknessLDL cholesterolLDL receptor |
| spellingShingle | Hayato Tada Nobuko Kojima Yasuaki Takeji Atsushi Nohara Masa-aki Kawashiri Masayuki Takamura Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia American Journal of Preventive Cardiology Familial hypercholesterolemia Achilles tendon thickness LDL cholesterol LDL receptor |
| title | Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia |
| title_full | Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia |
| title_fullStr | Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia |
| title_full_unstemmed | Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia |
| title_short | Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia |
| title_sort | impact of changes in achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia |
| topic | Familial hypercholesterolemia Achilles tendon thickness LDL cholesterol LDL receptor |
| url | http://www.sciencedirect.com/science/article/pii/S266666772400028X |
| work_keys_str_mv | AT hayatotada impactofchangesinachillestendonthickeningoncardiovasculareventsinpatientswithfamilialhypercholesterolemia AT nobukokojima impactofchangesinachillestendonthickeningoncardiovasculareventsinpatientswithfamilialhypercholesterolemia AT yasuakitakeji impactofchangesinachillestendonthickeningoncardiovasculareventsinpatientswithfamilialhypercholesterolemia AT atsushinohara impactofchangesinachillestendonthickeningoncardiovasculareventsinpatientswithfamilialhypercholesterolemia AT masaakikawashiri impactofchangesinachillestendonthickeningoncardiovasculareventsinpatientswithfamilialhypercholesterolemia AT masayukitakamura impactofchangesinachillestendonthickeningoncardiovasculareventsinpatientswithfamilialhypercholesterolemia |