Article (Scientific journals)
A Belgian consensus strategy to identify familial hypercholesterolaemia in the coronary care unit and its subsequent cascade screening and treatment: BEL-FaHST (The BELgium Familial Hypercholesterolaemia STrategy)
Descamps, O. S.; Van Caenegem, O.; Hermans, Michel et al.
2018In Atherosclerosis, 277, p. 369-376
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Keywords :
Autosomal dominant lipoprotein disorder; Cardiovascular disease; Coronary care unit; Familial hypercholesterolaemia; Low-density lipoprotein cholesterol
Abstract :
[en] Background and aims: Familial hypercholesterolaemia (FH) is an autosomal dominant lipoprotein disorder characterized by significant elevation of low-density lipoprotein cholesterol (LDL-C) and markedly increased risk of premature cardiovascular disease (CVD). Because of the very high coronary artery disease risk associated with this condition, the prevalence of FH among patients admitted for CVD outmatches many times the prevalence in the general population. Awareness of this disease is crucial for recognizing FH in the aftermath of a hospitalization of a patient with CVD, and also represents a unique opportunity to identify relatives of the index patient, who are unaware they have FH. This article aims to describe a feasible strategy to facilitate the detection and management of FH among patients hospitalized for CVD. Methods: A multidisciplinary national panel of lipidologists, cardiologists, endocrinologists and cardio-geneticists developed a three-step diagnostic algorithm, each step including three key aspects of diagnosis, treatment and family care. Results: A sequence of tasks was generated, starting with the process of suspecting FH amongst affected patients admitted for CVD, treating them to LDL-C target, finally culminating in extensive cascade-screening for FH in their family. Conceptually, the pathway is broken down into 3 phases to provide the treating physicians with a time-efficient chain of priorities. Conclusions: We emphasize the need for optimal collaboration between the various actors, starting with a “vigilant doctor” who actively develops the capability or framework to recognize potential FH patients, continuing with an “FH specialist” and finally involving the patient himself as ”FH ambassador” to approach his/her family and facilitate cascade screening and subsequent treatment of relatives. © 2018 Elsevier B.V.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Descamps, O. S.;  Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul and Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
Van Caenegem, O.;  Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
Hermans, Michel;  Department of Endocrinology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
Balligand, J.-L.;  Department of Internal Medecine, Cliniques Universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique, UCL, Bruxelles, Belgium
Beauloye, C.;  Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
Bondue, A.;  Department of Cardiology and Centre for Human Genetics, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
Carlier, S.;  Department of Cardiology, Centre Hospitalier Universitaire, Ambroise Paré and Mons University (UMONS), Mons, Belgium
CASTERMANS, Emilie 
Chenot, F.;  Department of Cardiology, Grand Hôpital de Charleroi, Belgium
Claeys, M.;  Department of Cardiology, University Hospital Antwerp, President of the Belgian Society of Cardiology, Belgium
De Block, C.;  Department of Endocrinology-diabetology-metabolism, UA Antwerp University Hospital, UA Universitair Ziekenhuis Antwerpen, Belgium
de Leener, A.;  Centre de Génétique Humaine, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
De Meester, A.;  Department of Cardiology, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium
Demeure, F.;  Department of Cardiology, Cliniques Universitaires de Mont-Godinne, Belgium
De Raedt, H.;  Department of Cardiology, Onze-Lieve-Vrouw Ziekenhuis, Aalst, Belgium
Desmet, W.;  Department of Cardiovascular Medicine, Universitaire Ziekenhuizen Leuven, University Hospitals Leuven, Belgium
Elegeert, I.;  Department of Cardiology, Algemeen Ziekenhuis, Groeninge, Kortrijk, Belgium
Hoffer, E.;  Department of Cardiology, Centre Hospitalier Régional de la Citadelle, Liège, Belgium
Kacenelenbogen, R.;  Department of Cardiology, CHU Saint-Pierre and President of the Working Group of Cardiovascular Readaptation and Prevention, Belgium
Lancellotti, Patrizio  ;  Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Langlois, M.;  Department of laboratory Medicine, Algemeen Ziekenhuis Sint-Jan, Brugge, and National Representative of the Royal Belgian Society of Laboratory Medicine, Belgium
Leone, A.;  Department of Cardiology, Centre Hospitalier Universitaire de Tivoli La Louvière, Belgium
Mertens, Anne
Paquot, Nicolas ;  Université de Liège - ULiège > Département des sciences de la santé publique > Diabétologie, nutrition et maladies métaboliques
Vanakker, O.;  Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
Vanoverschelde, J.-L.;  Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
Verhaegen, A.;  Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerpen, Belgium
Vermeersch, P.;  Department of laboratory Medicine, Senior Clinical Investigator of the Research Foundation-Flanders (FWO), University Hospital Leuven, The Royal Belgian Society of Laboratory Medicine, Belgium
WALLEMACQ, Caroline ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de diabétologie, nutrition, maladies métaboliques
Rietzschel, E.;  Department of Cardiology, University Hospital Ghent and Ghent University, Belgium
Belgian Atherosclerosis Society/Belgian Lipid Club (BAS/BLC), The Belgian Society Of Cardiology B. S. C. And The Royal Belgian Society Of Laboratory Medicine Rbslm
More authors (22 more) Less
Language :
English
Title :
A Belgian consensus strategy to identify familial hypercholesterolaemia in the coronary care unit and its subsequent cascade screening and treatment: BEL-FaHST (The BELgium Familial Hypercholesterolaemia STrategy)
Publication date :
2018
Journal title :
Atherosclerosis
ISSN :
0021-9150
eISSN :
1879-1484
Publisher :
Elsevier Ireland Ltd
Volume :
277
Pages :
369-376
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
Abbott Laboratories [US-IL] [US-IL]
AstraZeneca [BE]
Bayer AG [DE]
Boehringer Ingelheim [DE]
MSD - Merck Sharp and Dohme [BE]
Mylan - Mylan Laboratories [US-PA] [US-PA]
Pfizer [AU]
Roche [BE]
Servier [FR]
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since 21 January 2019

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