Impact of changes in Achilles tendon thickening on cardiovascular events in patients with familial hypercholesterolemia

• Published in: American journal of preventive cardiology Vol. 18; p. 100660
• Main Authors: Tada, Hayato, Kojima, Nobuko, Takeji, Yasuaki, Nohara, Atsushi, Kawashiri, Masa-aki, Takamura, Masayuki
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2024; Elsevier
• Subjects: Achilles tendon thickness; Cardiovascular; Familial hypercholesterolemia; LDL cholesterol; LDL receptor; Original Research; Achilles tendon thickness; Familial hypercholesterolemia; LDL cholesterol; LDL receptor
• ISSN: 2666-6677; 2666-6677
• DOI: 10.1016/j.ajpc.2024.100660

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). 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. 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). Assessing ATT has diagnostic value and allows for risk stratification among patients with HeFH. Impact of changes of Achilles tendon thickening on the prognosis of patients with FH When patients were divided into 4 groups based on the changes of their status of Achilles tendon thickening, we found there were significant differences of their prognosis. [Display omitted]