MYOCARDIAL SILENT INFARCTIONS AND FIBROSIS IN FAMILIAL HYPERCHOLESTEROLEMIA (CHOLCOEUR)

NCT02517944 | Unknown

• 1 other identifier: 14DRM_CHOLCOEUR
• Study Type: observational
• Target: 110
• Locations: 1 country
• Sites: 1

Brief Summary

Patients with familial hypercholesterolemia (FH) at high cardiovascular risk may suffer from silent micro-infarctions (MI) before clinical coronary heart disease manifestations because of the lifetime exposure to elevated serum LDL-cholesterol levels. The study aims to demonstrate the higher prevalence of silent myocardial infarction in a population of asymptomatic patients with familial hypercholesterolemia at high cardiovascular risk in comparison to control patients using Cardiac Magnetic Resonance sequences of delayed gadolinium enhancement.

Conditions

Familial Hypercholesterolemia - Heterozygous

Keywords

Familial hypercholesterolemia

Outcome Measures

Primary Outcomes (1)

• Percentage of patients presenting with at least one micro infarction at RMI

  Cardiac and aortic RMI with gadolinium

  Within 4 weeks after consent signature

Secondary Outcomes (3)

• LDL-Cholesterol burden (compared to standard values)

  The most recent value within the last 5 years.

• Anatomic and functional indexes of the aorta (maximal and minimal areas of aortic lumen, aortic flow)

  Within 4 weeks after consent signature

• Correlations between LDL-Cholesterol burden & presence of micro infarction, between LDL-Cholesterol burden & myocardial fibrosis, and between LDL-Cholesterol burden & aortic stiffness indexes

  1 year

Study Arms (2)

Familial hypercholesterolemia patients

* clinical data * biological data * cardiac and aortic RMI with gadolinium

Control group

* clinical data * biological data * cardiac and aortic RMI with gadolinium

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

110 subjects divided into: * 75 patients with heterozygous form at high cardiovascular risk * 35 controls patients without dyslipidaemia

You may qualify if:

• For patients with heterozygous form of familial hypercholesterolemia:
• Aged between 40 and 60 years
• With an identified genetic mutation (LDL-R, ApoB, PCSK9)
• Asymptomatic,
• With no EKG sign of ischemia
• No personal history of coronary heart disease.
• Treated or untreated by lipid lowering treatment
• High cardiovascular risk identified by 1 of the following criteria:
• \. Current smoking (1 cigarette a day) 2 Family history of very premature onset CHD: first- or second-degree male relative onset before age 45, first- or second-degree female relative onset before age 55 3.Two or more cardiovascular risk factors among this list: increasing age (men \> 30, women \> 40 years of age), LDL-C \> 250 mg/dL, male sex, family history of premature onset CHD, first-degree male relative onset before age 55, first-degree female relative onset before age 65, metabolic syndrome, HDL-C \< 40 mg/dL, hypertension (BP \> 140/or \> 90 mmHg or drug treatment), Lp (a) ≥ 50 mg/dL, tendon xanthoma
• For control subjects:
• Aged between 40 and 60 years
• With a normal lipid profile (LDL-C \< 1.6g/L HDL-C \> 0,45g/L and TG \< 4g/L) and untreated by any lipid lowering therapies
• Asymptomatic,
• With EKG showing normal sinus rhythm , no sign of ischemia nor Left Bundle Branch Block
• No personal history of coronary heart disease.

You may not qualify if:

• Non-affiliation to a healthcare system
• Consent refusal
• Contra-indication to MRI or to gadolinium injection.
• Claustrophobia, metallic devices, pacemaker, mechanical valve implanted before 1985, pregnancy, nursing
• Renal failure
• Technical contra-indication: patient diameter \> 70 cm weight \> 250 kg
• Personal history of cardiovascular disease and myocardial infarction
• Diabetes mellitus
• Uncontrolled hypertension
• TG \< 4 g/L
• Previous use of an Amgen product in the past 12 months

Sponsors & Collaborators

• Institute of Cardiometabolism and Nutrition, France: lead
• Amgen: collaborator

Study Sites (1)

Unité de prévention des maladies cardiovasculaires- Unité INSERM 939 Pôle Cardiologie/Métabolisme Groupe Hospitalier Pitié-Salpêtrière

Paris, 75013, France

RECRUITING

Related Publications (28)

• Hovingh GK, Davidson MH, Kastelein JJ, O'Connor AM. Diagnosis and treatment of familial hypercholesterolaemia. Eur Heart J. 2013 Apr;34(13):962-71. doi: 10.1093/eurheartj/eht015. Epub 2013 Feb 14.

  PMID: 23416791 BACKGROUND

• Nemati MH, Astaneh B. Optimal management of familial hypercholesterolemia: treatment and management strategies. Vasc Health Risk Manag. 2010 Dec 3;6:1079-88. doi: 10.2147/VHRM.S8283.

  PMID: 21191428 BACKGROUND

• Descamps OS, Gilbeau JP, Leysen X, Van Leuven F, Heller FR. Impact of genetic defects on atherosclerosis in patients suspected of familial hypercholesterolaemia. Eur J Clin Invest. 2001 Nov;31(11):958-65. doi: 10.1046/j.1365-2362.2001.00915.x.

  PMID: 11737238 BACKGROUND

• Austin MA, Hutter CM, Zimmern RL, Humphries SE. Familial hypercholesterolemia and coronary heart disease: a HuGE association review. Am J Epidemiol. 2004 Sep 1;160(5):421-9. doi: 10.1093/aje/kwh237.

  PMID: 15321838 BACKGROUND

• Risk of fatal coronary heart disease in familial hypercholesterolaemia. Scientific Steering Committee on behalf of the Simon Broome Register Group. BMJ. 1991 Oct 12;303(6807):893-6. doi: 10.1136/bmj.303.6807.893.

  PMID: 1933004 BACKGROUND

• Kroon AA, Ajubi N, van Asten WN, Stalenhoef AF. The prevalence of peripheral vascular disease in familial hypercholesterolaemia. J Intern Med. 1995 Nov;238(5):451-9. doi: 10.1111/j.1365-2796.1995.tb01223.x.

  PMID: 7595185 BACKGROUND

• Kolansky DM, Cuchel M, Clark BJ, Paridon S, McCrindle BW, Wiegers SE, Araujo L, Vohra Y, Defesche JC, Wilson JM, Rader DJ. Longitudinal evaluation and assessment of cardiovascular disease in patients with homozygous familial hypercholesterolemia. Am J Cardiol. 2008 Dec 1;102(11):1438-43. doi: 10.1016/j.amjcard.2008.07.035. Epub 2008 Sep 11.

  PMID: 19026292 BACKGROUND

• Benn M, Watts GF, Tybjaerg-Hansen A, Nordestgaard BG. Familial hypercholesterolemia in the danish general population: prevalence, coronary artery disease, and cholesterol-lowering medication. J Clin Endocrinol Metab. 2012 Nov;97(11):3956-64. doi: 10.1210/jc.2012-1563. Epub 2012 Aug 14.

  PMID: 22893714 BACKGROUND

• Farnier M, Bruckert E. Severe familial hypercholesterolaemia: current and future management. Arch Cardiovasc Dis. 2012 Dec;105(12):656-65. doi: 10.1016/j.acvd.2012.05.011. Epub 2012 Oct 6.

  PMID: 23199621 BACKGROUND

• Vilahur G, Casani L, Juan-Babot O, Guerra JM, Badimon L. Infiltrated cardiac lipids impair myofibroblast-induced healing of the myocardial scar post-myocardial infarction. Atherosclerosis. 2012 Oct;224(2):368-76. doi: 10.1016/j.atherosclerosis.2012.07.003. Epub 2012 Jul 22.

  PMID: 22882904 BACKGROUND

• Kaufmann PA, Gnecchi-Ruscone T, Schafers KP, Luscher TF, Camici PG. Low density lipoprotein cholesterol and coronary microvascular dysfunction in hypercholesterolemia. J Am Coll Cardiol. 2000 Jul;36(1):103-9. doi: 10.1016/s0735-1097(00)00697-5.

  PMID: 10898420 BACKGROUND

• Dayanikli F, Grambow D, Muzik O, Mosca L, Rubenfire M, Schwaiger M. Early detection of abnormal coronary flow reserve in asymptomatic men at high risk for coronary artery disease using positron emission tomography. Circulation. 1994 Aug;90(2):808-17. doi: 10.1161/01.cir.90.2.808.

  PMID: 8044952 BACKGROUND

• Giulia Gagliardi M, Crea F, Polletta B, Bassano C, La Vigna G, Ballerini L, Ragonese P. Coronary microvascular endothelial dysfunction in transplanted children. Eur Heart J. 2001 Feb;22(3):254-60. doi: 10.1053/euhj.2001.2105.

  PMID: 11161937 BACKGROUND

• Watts GF, Sullivan DR, Poplawski N, van Bockxmeer F, Hamilton-Craig I, Clifton PM, O'Brien R, Bishop W, George P, Barter PJ, Bates T, Burnett JR, Coakley J, Davidson P, Emery J, Martin A, Farid W, Freeman L, Geelhoed E, Juniper A, Kidd A, Kostner K, Krass I, Livingston M, Maxwell S, O'Leary P, Owaimrin A, Redgrave TG, Reid N, Southwell L, Suthers G, Tonkin A, Towler S, Trent R; Familial Hypercholesterolaemia Australasia Network Consensus Group (Australian Atherosclerosis Society). Familial hypercholesterolaemia: a model of care for Australasia. Atheroscler Suppl. 2011 Oct;12(2):221-63. doi: 10.1016/j.atherosclerosissup.2011.06.001. Epub 2011 Sep 13.

  PMID: 21917530 BACKGROUND

• De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, Ebrahim S, Faergeman O, Graham I, Mancia G, Cats VM, Orth-Gomer K, Perk J, Pyorala K, Rodicio JL, Sans S, Sansoy V, Sechtem U, Silber S, Thomsen T, Wood D; European Society of Cardiology. American Heart Association. American College of Cardiology. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts). Atherosclerosis. 2004 Apr;173(2):381-91. No abstract available.

  PMID: 15195638 BACKGROUND

• Nordestgaard BG, Chapman MJ, Humphries SE, Ginsberg HN, Masana L, Descamps OS, Wiklund O, Hegele RA, Raal FJ, Defesche JC, Wiegman A, Santos RD, Watts GF, Parhofer KG, Hovingh GK, Kovanen PT, Boileau C, Averna M, Boren J, Bruckert E, Catapano AL, Kuivenhoven JA, Pajukanta P, Ray K, Stalenhoef AF, Stroes E, Taskinen MR, Tybjaerg-Hansen A; European Atherosclerosis Society Consensus Panel. Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. Eur Heart J. 2013 Dec;34(45):3478-90a. doi: 10.1093/eurheartj/eht273. Epub 2013 Aug 15.

  PMID: 23956253 BACKGROUND

• Kwong RY, Sattar H, Wu H, Vorobiof G, Gandla V, Steel K, Siu S, Brown KA. Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction. Circulation. 2008 Sep 2;118(10):1011-20. doi: 10.1161/CIRCULATIONAHA.107.727826. Epub 2008 Aug 25.

  PMID: 18725488 BACKGROUND

• Mewton N, Liu CY, Croisille P, Bluemke D, Lima JA. Assessment of myocardial fibrosis with cardiovascular magnetic resonance. J Am Coll Cardiol. 2011 Feb 22;57(8):891-903. doi: 10.1016/j.jacc.2010.11.013.

  PMID: 21329834 BACKGROUND

• Choi DS, Ha JW, Choi B, Yang WI, Choi EY, Rim SJ, Chung N. Extent of late gadolinium enhancement in cardiovascular magnetic resonance and its relation with left ventricular diastolic function in patients with hypertrophic cardiomyopathy. Circ J. 2008 Sep;72(9):1449-53. doi: 10.1253/circj.cj-07-0874.

  PMID: 18724020 BACKGROUND

• Lin Y, Yang SG, Chen H, Zhang HQ, Wang CS. [The predictive value of DE-CMR in patients with severe chronic aortic regurgitation and extremely dilated left ventricular chamber]. Zhonghua Wai Ke Za Zhi. 2012 Dec;50(12):1087-90. Chinese.

  PMID: 23336485 BACKGROUND

• Kuruvilla S, Adenaw N, Katwal AB, Lipinski MJ, Kramer CM, Salerno M. Late gadolinium enhancement on cardiac magnetic resonance predicts adverse cardiovascular outcomes in nonischemic cardiomyopathy: a systematic review and meta-analysis. Circ Cardiovasc Imaging. 2014 Mar;7(2):250-258. doi: 10.1161/CIRCIMAGING.113.001144. Epub 2013 Dec 20.

  PMID: 24363358 BACKGROUND

• Lipinski MJ, McVey CM, Berger JS, Kramer CM, Salerno M. Prognostic value of stress cardiac magnetic resonance imaging in patients with known or suspected coronary artery disease: a systematic review and meta-analysis. J Am Coll Cardiol. 2013 Aug 27;62(9):826-38. doi: 10.1016/j.jacc.2013.03.080. Epub 2013 May 30.

  PMID: 23727209 BACKGROUND

• Mascherbauer J, Marzluf BA, Tufaro C, Pfaffenberger S, Graf A, Wexberg P, Panzenbock A, Jakowitsch J, Bangert C, Laimer D, Schreiber C, Karakus G, Hulsmann M, Pacher R, Lang IM, Maurer G, Bonderman D. Cardiac magnetic resonance postcontrast T1 time is associated with outcome in patients with heart failure and preserved ejection fraction. Circ Cardiovasc Imaging. 2013 Nov;6(6):1056-65. doi: 10.1161/CIRCIMAGING.113.000633. Epub 2013 Sep 13.

  PMID: 24036385 BACKGROUND

• Dall'Armellina E, Ferreira VM, Kharbanda RK, Prendergast B, Piechnik SK, Robson MD, Jones M, Francis JM, Choudhury RP, Neubauer S. Diagnostic value of pre-contrast T1 mapping in acute and chronic myocardial infarction. JACC Cardiovasc Imaging. 2013 Jun;6(6):739-42. doi: 10.1016/j.jcmg.2012.11.020. No abstract available.

  PMID: 23764100 BACKGROUND

• Liu CY, Liu YC, Wu C, Armstrong A, Volpe GJ, van der Geest RJ, Liu Y, Hundley WG, Gomes AS, Liu S, Nacif M, Bluemke DA, Lima JAC. Evaluation of age-related interstitial myocardial fibrosis with cardiac magnetic resonance contrast-enhanced T1 mapping: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2013 Oct 1;62(14):1280-1287. doi: 10.1016/j.jacc.2013.05.078. Epub 2013 Jul 17.

  PMID: 23871886 BACKGROUND

• Sacre K, Brihaye B, Hyafil F, Serfaty JM, Escoubet B, Zennaro MC, Lidove O, Laissy JP, Papo T. Asymptomatic myocardial ischemic disease in antiphospholipid syndrome: a controlled cardiac magnetic resonance imaging study. Arthritis Rheum. 2010 Jul;62(7):2093-100. doi: 10.1002/art.27488.

  PMID: 20506512 BACKGROUND

• Cheng HM, Ye ZX, Chiou KR, Lin SJ, Charng MJ. Vascular stiffness in familial hypercholesterolaemia is associated with C-reactive protein and cholesterol burden. Eur J Clin Invest. 2007 Mar;37(3):197-206. doi: 10.1111/j.1365-2362.2007.01772.x.

  PMID: 17359487 BACKGROUND

• Schmidt HH, Hill S, Makariou EV, Feuerstein IM, Dugi KA, Hoeg JM. Relation of cholesterol-year score to severity of calcific atherosclerosis and tissue deposition in homozygous familial hypercholesterolemia. Am J Cardiol. 1996 Mar 15;77(8):575-80. doi: 10.1016/s0002-9149(97)89309-5.

  PMID: 8610605 BACKGROUND

MeSH Terms

Conditions

Hyperlipoproteinemia Type II

Condition Hierarchy (Ancestors)

Lipid Metabolism, Inborn Errors; Metabolism, Inborn Errors; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Hyperlipoproteinemias; Hyperlipidemias; Dyslipidemias; Lipid Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Study Officials

• David Rosenbaum, MD

  Study principal investigator

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Aurélie RABIER

CONTACT

a.rabier@ican-institute.org

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Target Duration: 4 Weeks
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 14, 2015
• First Posted: August 7, 2015
• Study Start: November 1, 2014
• Primary Completion: September 1, 2015
• Study Completion: November 1, 2015
• Last Updated: August 7, 2015

Record last verified: 2015-07

Locations

FR (1)