Efficacy and Safety of Lovastatin in Adolescent Males With Heterozygous Familial Hypercholesterolemia

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Abstract
Familial hypercholesterolemia (FH) is a dominant genetic disorder first described by Muller1 nearly 60 years ago. The elevated circulating low-density lipoprotein cholesterol (LDL-C) levels found in FH are caused by a defect in receptor-mediated LDL clearance2 and are the underlying cause of the marked increase in early coronary artery disease (CAD).3 In men with untreated heterozygous FH (HeFH), the risk of clinically overt CAD is approximately 5% by age 30 years, 20% by age 40 years, and 50% by age 50 years.3,4 Only about 15% of men with HeFH reach age 65 years without experiencing an ischemic coronary event.4 If left untreated, 23% of men experience fatal coronary events by age 50 years. Furthermore, the location and extent of coronary lesions in patients with HeFH suggest a prognosis worse than that of patients without FH; in 1 study, 70% of patients with HeFH had triple-vessel CAD and 32% had left main vessel disease.5