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Clinical and Subclinical Atherosclerotic Disease in Adolescents With Familial Hypercholesterolemia

Year: 2026

Type: article

Abstract: Familial hypercholesterolemia is primarily a disorder of reduced low-density lipoprotein (LDL) clearance, which can be inherited in either homozygous or heterozygous form. Despite the availability of various modalities to achieve target LDL cholesterol levels, inadequate control remains a significant risk factor for accelerated atherosclerosis in the pediatric population. Moreover, the occurrence of coronary artery disease in adolescents poses unique management challenges given the limited representation of this age group in clinical trials. We report 2 cases of coronary artery disease and 1 case of subclinical atherosclerosis in adolescent patients with genetically confirmed familial hypercholesterolemia, outlining the diagnostic work-up, challenges in achieving LDL cholesterol control, measures undertaken, including plasma exchange, and revascularization strategies using drug-eluting stents or drug-coated balloons, in accordance with current guidelines.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106600

Authors: Sura Kishore Mishra, Pankaj Kumar Maravi, Bitan Mohanty, Santoshi Shamad

Institution: Sriram Chandra Bhanja Medical College Hospital

Language: English

Topic: Lipoproteins and Cardiovascular Health

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850