Loss of statin treatment years during pregnancy and breastfeeding periods in women with familial hypercholesterolemia,Atherosclerosis

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Loss of statin treatment years during pregnancy and breastfeeding periods in women with familial hypercholesterolemia
Atherosclerosis ( IF 4.9 ) Pub Date : 2021-09-03 , DOI: 10.1016/j.atherosclerosis.2021.09.003
Marianne Klevmoen ₁ , Martin P Bogsrud ₂ , Kjetil Retterstøl ₃ , Tone Svilaas ₄ , Elisabeth K Vesterbekkmo ₅ , Anders Hovland ₆ , Christ Berge ₇ , Jeanine Roeters van Lennep ₈ , Kirsten B Holven ₁

Affiliation

Background and aims

Women with heterozygous familial hypercholesterolemia (FH) are recommended to initiate statin treatment at the same age as men (from 8 to 10 years of age). However, statins are contraindicated when pregnancy is planned, during pregnancy and breastfeeding. The aim of the study was to determine the duration of pregnancy-related off-statin periods and breastfeeding in FH women.

Methods

A cross-sectional study using an anonymous online self-administered questionnaire was conducted. Women with FH were recruited through Lipid Clinics in Norway and Netherlands and national FH patient organizations.

Results

102 women with FH (n = 70 Norwegian and n = 32 Dutch) were included in the analysis. Total length of pregnancy-related off-statin periods was estimated for 80 women where data were available, and was median (min-max) 2.3 (0–14.2) years. Lost statin treatment time was estimated for 67 women where data were available, and was median (min-max) 18 (0–100)% at mean (SD) age of 31 (4.3) years at last pregnancy. More women breastfed in Norway (83%) and for longer time [8.5 [1-42] months] compared to the Netherlands [63%, p = 0.03; 3.6 (0–14) months, p < 0.001]. Eighty-six percent of the women reported need for more information on pregnancy and breastfeeding in relation to FH.

Conclusions

Young FH women lose years of treatment when discontinuing statins in relation to pregnancy and breastfeeding periods and should be closely followed up to minimize the duration of these off-statin periods. Whether these periods of interrupted treatment increase the cardiovascular risk in FH women needs to be further elucidated.

中文翻译：

家族性高胆固醇血症女性在怀孕和哺乳期间失去他汀类药物治疗年数

背景和目标

建议患有杂合子家族性高胆固醇血症 (FH) 的女性在与男性相同的年龄（8 至 10 岁）开始他汀类药物治疗。然而，在计划怀孕期间、怀孕期间和哺乳期间禁用他汀类药物。该研究的目的是确定 FH 女性与妊娠相关的停用他汀类药物和母乳喂养的持续时间。

方法

进行了一项使用匿名在线自我管理问卷的横断面研究。FH 女性是通过挪威和荷兰的脂质诊所以及国家 FH 患者组织招募的。

结果

102 名 FH 女性（n = 70 挪威人，n = 32 荷兰人）被纳入分析。在有数据的情况下，估计了 80 名妇女的妊娠相关停用他汀类药物期间的总长度，中位数（最小值-最大值）为 2.3 (0-14.2) 年。在有数据的情况下，估计 67 名女性的他汀类药物治疗时间损失，在上次怀孕时的平均 (SD) 年龄为 31 (4.3) 岁时，中位数（最小值-最大值）为 18 (0–100)%。与荷兰 [63%，p = 0.03；3.6 (0–14) 个月，p < 0.001]。86% 的女性报告需要更多关于 FH 的怀孕和母乳喂养信息。