Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel

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dc.contributor.authorBjelakovic, Bojko
dc.contributor.authorStefanutti, Claudia
dc.contributor.authorReiner, Željko
dc.contributor.authorWatts, Gerald F
dc.contributor.authorMoriarty, Patrick
dc.contributor.authorMarais, David
dc.contributor.authorWidhalm, Kurt
dc.contributor.authorCohen, Hofit
dc.contributor.authorHarada-Shiba, Mariko
dc.contributor.authorBanach, Maciej
dc.date.accessioned2021-11-22T11:29:22Z
dc.date.available2021-11-22T11:29:22Z
dc.date.issued2021-10-25
dc.date.updated2021-11-11T14:57:25Z
dc.description.abstractHeterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipid lowering therapy irrespective of the presence of CV risk factors, family history and/or LDL-C levels Those children with FH and cIMT ≥0.4 mm should be carefully monitored to initiate lipid lowering management in the most suitable time. Likewise, all genetically confirmed children with FH and LDL-C levels ≥4.1 mmol/L (160 mg/dL), should be treated with lifestyle changes and LLT irrespective of the cIMT, presence of additional RF or family history of CHD.en_US
dc.identifierdoi: 10.3390/jcm10214930
dc.identifier.apacitationBjelakovic, B., Stefanutti, C., Reiner, Ž., Watts, G. F., Moriarty, P., Marais, D., ... Banach, M. (2021). Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel. <i>Journal of Clinical Medicine</i>, 10(21), 4930. http://hdl.handle.net/11427/35351en_ZA
dc.identifier.chicagocitationBjelakovic, Bojko, Claudia Stefanutti, Željko Reiner, Gerald F Watts, Patrick Moriarty, David Marais, Kurt Widhalm, Hofit Cohen, Mariko Harada-Shiba, and Maciej Banach "Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel." <i>Journal of Clinical Medicine</i> 10, 21. (2021): 4930. http://hdl.handle.net/11427/35351en_ZA
dc.identifier.citationBjelakovic, B., Stefanutti, C., Reiner, Ž., Watts, G.F., Moriarty, P., Marais, D., Widhalm, K. & Cohen, H. et al. 2021. Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel. <i>Journal of Clinical Medicine.</i> 10(21):4930. http://hdl.handle.net/11427/35351en_ZA
dc.identifier.ris TY - Journal Article AU - Bjelakovic, Bojko AU - Stefanutti, Claudia AU - Reiner, Željko AU - Watts, Gerald F AU - Moriarty, Patrick AU - Marais, David AU - Widhalm, Kurt AU - Cohen, Hofit AU - Harada-Shiba, Mariko AU - Banach, Maciej AB - Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipid lowering therapy irrespective of the presence of CV risk factors, family history and/or LDL-C levels Those children with FH and cIMT ≥0.4 mm should be carefully monitored to initiate lipid lowering management in the most suitable time. Likewise, all genetically confirmed children with FH and LDL-C levels ≥4.1 mmol/L (160 mg/dL), should be treated with lifestyle changes and LLT irrespective of the cIMT, presence of additional RF or family history of CHD. DA - 2021-10-25 DB - OpenUCT DP - University of Cape Town IS - 21 J1 - Journal of Clinical Medicine LK - https://open.uct.ac.za PY - 2021 T1 - Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel TI - Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel UR - http://hdl.handle.net/11427/35351 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35351
dc.identifier.vancouvercitationBjelakovic B, Stefanutti C, Reiner Ž, Watts GF, Moriarty P, Marais D, et al. Risk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panel. Journal of Clinical Medicine. 2021;10(21):4930. http://hdl.handle.net/11427/35351.en_ZA
dc.language.isoenen_US
dc.publisher.departmentDepartment of Pathologyen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceJournal of Clinical Medicineen_US
dc.source.journalissue21en_US
dc.source.journalvolume10en_US
dc.source.pagination4930en_US
dc.source.urihttps://www.mdpi.com/journal/jcm
dc.titleRisk assessment and clinical management of children and adolescents with Heterozygous Familial Hypercholesterolaemia. a position paper of the associations of preventive pediatrics of Serbia, mighty medic and international lipid expert panelen_US
dc.typeJournal Articleen_US
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