Summary of physicians’ responses to questions about FH knowledge, practice, detection, and awareness.

<p>Summary of physicians’ responses to questions about FH knowledge, practice, detection, and awareness.</p

Assessment of physicians’ awareness and knowledge of familial hypercholesterolemia in Saudi Arabia: Is there a gap?

<div><p>Background</p><p>The scarcity of familial hypercholesterolemia (FH) cases reported in Saudi Arabia might be indicative of a lack of awareness of this common genetic disease among physicians.</p><p>Objective</p><p>To assess physicians’ awareness, practice, and knowledge of FH in Saudi Arabia.</p><p>Methods</p><p>This is a cross-sectional study conducted among physicians at four tertiary hospitals in Riyadh, Saudi Arabia between March 2016 and May 2016 using a self-administered questionnaire.</p><p>Results</p><p>A total of 294 physicians completed the survey (response rate 90.1%). Overall, 92.9% of the participants have poor knowledge of FH while only 7.1% have acceptable knowledge. The majority (68.7%) of physicians rated their familiarity with FH as average or above average, and these had higher mean knowledge scores than participants with self-reported below average familiarity (mean 3.4 versus 2.6) (P < 0.001). Consultant physicians were 4.2 times more likely to be familiar with FH than residents or registrars (OR = 4.2, 95% CI = 1.9–9.1, P < 0.001). Physicians who currently managed FH patients had higher mean knowledge scores compared to those without FH patients in their care (3.5 versus 2.9) (P = 0.006). In addition, there were statistically significant differences between physicians’ mean knowledge scores and their ages, levels of training, and years in practice. Moreover, a substantial deficit was identified in the awareness of various clinical algorithms to diagnose patients with FH, cascade screening, specialist lipid services, and the existence of statin alternatives, such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.</p><p>Conclusion</p><p>A substantial deficit was found in the awareness, knowledge, practice, and detection of FH among physicians in Saudi Arabia. Extensive educational programs are required to raise physician awareness and implement best practices; only then can the impact of these interventions on FH management and patient outcome be assessed.</p></div

Summary of physician responses to the most selected risk factors that further increase the CV risk of patients with FH.

<p>Summary of physician responses to the most selected risk factors that further increase the CV risk of patients with FH.</p

Physicians’ demographics (n = 294).

<p>Physicians’ demographics (n = 294).</p

Familiarity with FH as predicted by physicians' characteristics.

<p>Familiarity with FH as predicted by physicians' characteristics.</p

Mean knowledge score by physicians’ characteristics and FH familiarity.

<p>Mean knowledge score by physicians’ characteristics and FH familiarity.</p

The relationship between FH familiarity and physicians’ demographics.

<p>The relationship between FH familiarity and physicians’ demographics.</p

Variables in model IV, and their effects on mortality.

<p>ORs for variables with multiple levels (country, diagnosis, and predominant symptoms) are not shown. The variables that were dropped out of the multivariable logistic regression using the stepwise-backward elimination method included: smoking, BMI, history of hypertension and hyperlipidaemia, clopidogrel as discharge medication, PCI, and CABG.</p>*<p>Predominant presenting symptoms includes: ischemic type chest pain, atypical chest pain, dyspnea, fatigue, loss of consciousness, cardiac arrest/aborted sudden death, palpitation and other symptoms.</p><p>Abbreviations: OR, odds ratio; CI, confidence interval; BB, beta-blockers; CCB, calcium channel blockers; ACE, angiotensin-converting enzyme inhibitors; AIIRB, angiotensin II receptor blockers.</p

In-hospital outcomes and 1-month and 1-year post discharge mortality of the study cohort by gender (n = 7930).

<p>Figures in parentheses are percentages.</p

Baseline characteristics of patients stratified by gender (n = 7930).

<p>Figures in parentheses are percentages and continuous variables are shown as mean±SD.</p><p>Abbreviations: SD, standard deviation; BMI, body mass index; CAD, coronary artery disease; MI, myocardial infarction; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft; CHF, congestive heart failure; STEMI, ST elevation myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction; UA, unstable angina.</p>*<p>Killip class (scale I–IV) a system used to stratify the severity of left ventricular dysfunction and determines clinical status of patients post myocardial infarction (MI).</p><p>Killip classification:</p><p>Class 1: No rales, no 3rd heart sound.</p><p>Class 2: Rales in <1/2 lung field or presence of a 3rd heart sound.</p><p>Class 3: Rales in >1/2 lung field–pulmonary edema.</p><p>Class 4: Cardiogenic shock–determined clinically.</p