M. Farnier1,2, B. Mouhat2, T. Pommier2, H. Yao2, M. Maza2, F. Chagué2, F. Bichat2, Y. Cottin2, M. Zeller3.
1Point Médical, LIpid Clinic, Dijon, France.
2University Hospital Center Dijon-Bourgogne, Cardiology, Dijon, France.
3University of Bourgogne Franche-Comté- UFR Sciences de Santé, Pec2- EA 7460, DIJON cedex, France.

Background and Aims:
Individuals with heterozygous familial hypercholesterolemia (FH) are at high risk of early myocardial infarction (MI). However, coronary artery disease (CAD) burden of FH remains not well described. From a large database of a regional registry of acute MI, we aimed to address prevalence of FH and severity of CAD.
Methods:
Consecutive patients hospitalized with MI in a multicentre database from 2001-2017 were considered.  An algorithm, adapted from Dutch Lipid Clinic Network criteria, was built upon 4 variables (LDL-cholesterol (LDL-C) level and chronic lipid lowering agents, premature and family history of CAD) to identify FH probabilities.
Results
Among the 11624 patients included in the survey, 249 (2.1%) had probable/definite FH (score≥6), and 2405 (20.7%) had possible FH (score 3-5). When compared with patients without FH (score 0-2), FH patients (score≥6) were 20y younger (51(46-57)vs71(61-80)y, p<0.001), with a lower rate of hypertension (47vs59%, p<0.001), diabetes (17vs25%, p<0.001) and prior stroke (4vs8%, p=0.016), but a higher prevalence of smokers (56vs23%, p<0.001), personal (20vs15%, p=0.02) or familial history of CAD (78vs18%, p<0.001). Chronic statin treatment was only used in 48% of FH patients and ezetimibe in 8%. After adjustment for age, sex and diabetes, FH patients were characterized by increased extent of CAD (syntax score 11(4-19)vs7(1-13), p<0.001) and multivessel disease (55vs40%, p<0.001).
Conclusions:
In this large real world population of acute MI, a high prevalence of FH was found. Moreover, FH patients were characterized by their young age associated with the severity of CAD burden and limited use of preventive lipid lowering therapy.

04 - PREVALENCE AND SEVERITY OF CORONARY DISEASE IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA HOSPITALIZED FOR AN ACUTE MYOCARDIAL INFARCTION: DATA FROM THE RICO SURVEY