Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients

Abstract Background Familial Hypercholesterolemia (FH) is a major risk factor for premature Coronary Artery Disease (CAD). Genetic testing is the gold standard for FH diagnosis. The purpose of this Observational Analytical Cross-sectional study was to estimate the proportion of genetically confirmed...

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Main Authors: Rania A. Zahwo, Ziad N. Rezk, Tamer M. Elwasify, Amr M. Zaki, Hoda M. El Assi, Eman Ramadan, Abdallah Y. Habib, Wael A. Hassan, Ahmed Abdel-Raouf, Ameera Ragheb, Amin F. Shaker, Khaled E. Amer, Heba Sh. Kassem
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Human Genomics
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Online Access:https://doi.org/10.1186/s40246-025-00769-y
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author Rania A. Zahwo
Ziad N. Rezk
Tamer M. Elwasify
Amr M. Zaki
Hoda M. El Assi
Eman Ramadan
Abdallah Y. Habib
Wael A. Hassan
Ahmed Abdel-Raouf
Ameera Ragheb
Amin F. Shaker
Khaled E. Amer
Heba Sh. Kassem
author_facet Rania A. Zahwo
Ziad N. Rezk
Tamer M. Elwasify
Amr M. Zaki
Hoda M. El Assi
Eman Ramadan
Abdallah Y. Habib
Wael A. Hassan
Ahmed Abdel-Raouf
Ameera Ragheb
Amin F. Shaker
Khaled E. Amer
Heba Sh. Kassem
author_sort Rania A. Zahwo
collection DOAJ
description Abstract Background Familial Hypercholesterolemia (FH) is a major risk factor for premature Coronary Artery Disease (CAD). Genetic testing is the gold standard for FH diagnosis. The purpose of this Observational Analytical Cross-sectional study was to estimate the proportion of genetically confirmed Familial Hypercholesterolemia in Patients with premature Coronary Artery Disease in a cohort of Egyptian patients. Methods Next generation sequencing (NGS) was conducted for 7 genes (LDLR , PCSK9 , APOB , APOE , ABCG5 , ABCG8 and LDLRAP1) commonly associated with FH in 94 patients with Premature CAD from 2 tertiary hospitals in Cairo and Alexandria, Egypt. Individuals were clinically assessed using the Dutch Lipid Network criteria and genetically-confirmed FH prevalence was analyzed. Results Fourteen patients had pathogenic or likely pathogenic mutations in LDLR , APOB , PCSK9 and LDLRAP1 genes. Three patients had homozygous autosomal dominant FH and another 3 patients had autosomal recessive hypercholesterolemia. In addition, 10 patients had rare variants of uncertain significance in LDLR , APOB , APOE , ABCG5 and ABCG8 genes. Conclusions The prevalence of genetically confirmed FH in premature CAD (PCAD) patients in this study was found to be 14.89%. The Dutch Lipid Clinic Network (DLCN) scoring system is suggested as a good screening tool for familial hypercholesterolemia but confirmatory genetic testing is essential for the accurate diagnosis and management of the patients. In Egypt, the high rate of consanguinity contributes to the high prevalence of both homozygous autosomal dominant and recessive FH.
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spelling doaj-art-6e37cb7174cf4f5cb5251e2a46daba502025-08-20T03:45:32ZengBMCHuman Genomics1479-73642025-06-0119111410.1186/s40246-025-00769-yCorrelation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patientsRania A. Zahwo0Ziad N. Rezk1Tamer M. Elwasify2Amr M. Zaki3Hoda M. El Assi4Eman Ramadan5Abdallah Y. Habib6Wael A. Hassan7Ahmed Abdel-Raouf8Ameera Ragheb9Amin F. Shaker10Khaled E. Amer11Heba Sh. Kassem12Clinical Genomics Center, Faculty of Medicine, Alexandria UniversityMedical Genetics Department, Armed Forces College of MedicineCardiology Department, Armed Forces College of MedicineCardiology Department, Faculty of Medicine, Alexandria UniversityClinical Genomics Center, Faculty of Medicine, Alexandria UniversityPharmacology and Toxicology Department, Faculty of Pharmacy, The British University in EgyptClinical Pathology Department, Military Medical AcademyEgypt Center for Research and Regenerative MedicineEgypt Center for Research and Regenerative MedicineEgypt Center for Research and Regenerative MedicineEgypt Center for Research and Regenerative MedicineEgypt Center for Research and Regenerative MedicineClinical Genomics Center, Faculty of Medicine, Alexandria UniversityAbstract Background Familial Hypercholesterolemia (FH) is a major risk factor for premature Coronary Artery Disease (CAD). Genetic testing is the gold standard for FH diagnosis. The purpose of this Observational Analytical Cross-sectional study was to estimate the proportion of genetically confirmed Familial Hypercholesterolemia in Patients with premature Coronary Artery Disease in a cohort of Egyptian patients. Methods Next generation sequencing (NGS) was conducted for 7 genes (LDLR , PCSK9 , APOB , APOE , ABCG5 , ABCG8 and LDLRAP1) commonly associated with FH in 94 patients with Premature CAD from 2 tertiary hospitals in Cairo and Alexandria, Egypt. Individuals were clinically assessed using the Dutch Lipid Network criteria and genetically-confirmed FH prevalence was analyzed. Results Fourteen patients had pathogenic or likely pathogenic mutations in LDLR , APOB , PCSK9 and LDLRAP1 genes. Three patients had homozygous autosomal dominant FH and another 3 patients had autosomal recessive hypercholesterolemia. In addition, 10 patients had rare variants of uncertain significance in LDLR , APOB , APOE , ABCG5 and ABCG8 genes. Conclusions The prevalence of genetically confirmed FH in premature CAD (PCAD) patients in this study was found to be 14.89%. The Dutch Lipid Clinic Network (DLCN) scoring system is suggested as a good screening tool for familial hypercholesterolemia but confirmatory genetic testing is essential for the accurate diagnosis and management of the patients. In Egypt, the high rate of consanguinity contributes to the high prevalence of both homozygous autosomal dominant and recessive FH.https://doi.org/10.1186/s40246-025-00769-yDLCNFamilial hypercholesterolemiaGenetic testingPremature CADIHDEgypt
spellingShingle Rania A. Zahwo
Ziad N. Rezk
Tamer M. Elwasify
Amr M. Zaki
Hoda M. El Assi
Eman Ramadan
Abdallah Y. Habib
Wael A. Hassan
Ahmed Abdel-Raouf
Ameera Ragheb
Amin F. Shaker
Khaled E. Amer
Heba Sh. Kassem
Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients
Human Genomics
DLCN
Familial hypercholesterolemia
Genetic testing
Premature CAD
IHD
Egypt
title Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients
title_full Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients
title_fullStr Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients
title_full_unstemmed Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients
title_short Correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of Egyptian patients
title_sort correlation between clinical classification and genetic analysis of familial hypercholesterolemia in premature coronary artery disease in a cohort of egyptian patients
topic DLCN
Familial hypercholesterolemia
Genetic testing
Premature CAD
IHD
Egypt
url https://doi.org/10.1186/s40246-025-00769-y
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