Premature Coronary Artery Disease and Familial Dyslipidemia in Patients Presenting With Acute Coronary Syndrome

Premature Coronary Artery Disease and Familial Dyslipidemia in Patients Presenting With Acute Coronary Syndrome: A Tertiary Cardiac Center Registry

This study aimed to explore the relationship between familial hypercholesterolemia and premature coronary artery disease, particularly in the context of acute coronary syndrome, by reviewing current evidence and highlighting the need for improved screening and aggressive lipid-lowering strategies in high-risk populations.

Study Overview

• Status: Completed
• Conditions: Coronary Artery Disease; Acute Coronary Syndrome; Premature; Familial Dyslipidemia
• Intervention / Treatment: Other: Cardiovascular risk assessment

Detailed Description

Dyslipidaemia and familial hypercholesterolemia (FH) are a common disorder that causes premature coronary artery disease.

The lifelong burden of elevated low-density lipoprotein cholesterol (LDL-C) in FH accelerates endothelial dysfunction and plaque formation, often culminating in acute coronary syndrome (ACS) at a young age. ACS in patients with undiagnosed FH may be their first clinical manifestation, underscoring the importance of early identification and intervention.

• Study Type: Observational
• Enrollment (Actual): 2000

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 12613
    • Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This was a prospective, cross-sectional, observational study conducted at the Department of Cardiology, Prince Khaled Ben Sultan, between December 2021 and March 2025. A total of 2,000 consecutive adult patients admitted with a confirmed diagnosis of coronary artery disease (CAD) were included.

Description

Inclusion Criteria:

• Age ≥18 years at the time of presentation.
• Both sexes.
• Confirmed diagnosis of coronary artery disease (CAD), established by clinical presentation, electrocardiographic findings, elevated cardiac biomarkers, and/or angiographic evidence of ≥50% luminal stenosis in at least one major coronary artery.
• Hospital admission to the participating cardiology department between [insert study period, e.g., January 2020 and December 2024] for acute coronary syndrome (ACS), including unstable angina, non-ST-elevation myocardial infarction (NSTEMI), or ST-elevation myocardial infarction (STEMI).
• Availability of complete clinical, laboratory, and echocardiographic data necessary for classification and analysis.

Exclusion Criteria:

• Incomplete medical records or missing essential laboratory, imaging, or demographic data.
• Secondary causes of dyslipidemia, including uncontrolled hypothyroidism, nephrotic syndrome, chronic liver disease, or use of lipid-altering medications (other than statins) before presentation.
• Previous congenital or structural heart disease, cardiomyopathy, or significant valvular heart disease unrelated to CAD.
• Severe chronic kidney disease (estimated glomerular filtration rate <30 mL/min/1.73 m²) or patients on dialysis.
• Autoimmune, inflammatory, or systemic diseases known to influence vascular inflammation or lipid metabolism.
• Malignancy or life expectancy <6 months due to non-cardiac causes.
• Pregnant or lactating women.
• Non-Saudi patients (focusing on Saudi population in southern region).

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Non-premature coronary artery disease; Males aged <55 years and females aged <65 years.	Other: Cardiovascular risk assessment; Participants underwent a standardized cardiovascular risk assessment that included detailed clinical evaluation, lipid profiling (Total Cholesterol, Low-Density Lipoprotein Cholesterol, High-Density Lipoprotein Cholesterol, and Triglycerides).
Premature coronary artery disease; Males aged ≥55 years and females aged ≥65 years.	Other: Cardiovascular risk assessment; Participants underwent a standardized cardiovascular risk assessment that included detailed clinical evaluation, lipid profiling (Total Cholesterol, Low-Density Lipoprotein Cholesterol, High-Density Lipoprotein Cholesterol, and Triglycerides).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dyslipidemia pattern in patients with acute coronary syndrome	Dyslipidemia pattern in patients with acute coronary syndrome was recorded.	Within 24 hours of hospital admission
Incidence of familial dyslipidemia among patients with acute coronary syndrome	Incidence of familial dyslipidemia among patients with acute coronary syndrome was recorded.	Within 24 hours of hospital admission

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2021
• Primary Completion (Actual): March 27, 2025
• Study Completion (Actual): March 27, 2025

Study Registration Dates

• First Submitted: November 25, 2025
• First Submitted That Met QC Criteria: November 25, 2025
• First Posted (Actual): December 5, 2025

Study Record Updates

• Last Update Posted (Actual): December 5, 2025
• Last Update Submitted That Met QC Criteria: November 25, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Vascular Diseases; Cardiovascular Diseases; Female Urogenital Diseases and Pregnancy Complications; Heart Diseases; Obstetric Labor, Premature; Obstetric Labor Complications; Pregnancy Complications; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Myocardial Ischemia; Premature Birth; Coronary Artery Disease; Acute Coronary Syndrome
• Other Study ID Numbers: AFHSRMREC/2023/CARDIOLOGY/678

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No