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Introduction Advancements in Cystic Fibrosis (CF) transmembrane conductance regulator modulators have significantly increased the life expectancy of people living with CF (PwCF). The increased longevity, changes in body composition and increased prevalence of diabetes and chronic kidney disease in this cohort has led to emerging concerns about their potential increased risk of cardiovascular disease (CVD).Aims We sought to assess the CVD risk in PwCF aged ≥40, and to determine if they are appropriately receiving lipid-lowering therapy in line with current guidelines.Methods We retrospectively calculated the 10-year CVD risk scores of PwCF aged ≥40 attending our National Referral Centre for Adults with CF between 2020 and 2023. This was calculated using the European Society of Cardiology (ESC) SCORE2 and SCORE2-Diabetes (for those with CF-related diabetes, CFRD) algorithms, and the World Health Organisation (WHO) CVD risk prediction charts. Clinical data were collected from patients’ most recent Annual Review documents. Age of diabetes diagnosis was standardized as five years prior to the assessment year.Results Of the 427 PwCF attending our CF unit, 100 were aged ≥40, and 77 had complete data for risk score calculation. Mean age was 47.6 years (SD ±6.1), 63.6% were male and 33.8% had CFRD. Using the WHO risk prediction chart, 63.6% of the 77 PwCF were classified as green-risk, 24.7% as yellow-risk, 10.4% as orange-risk, and 1.3% as red-risk. Of the 26 PwCF with CFRD, SCORE2-Diabetes classified 46.2% as low-risk, 46.2% as moderate-risk, and 7.6% as high-risk. Of the 51 PwCF without CFRD, SCORE2 classified 78.4% as low-to-moderate-risk and 21.6% as high-risk. Based on ESC guidelines, 19.5% of the included PwCF would be candidates for lipid-lowering therapy. However, only 9.1% were prescribed either a statin or ezetimibe.Abstract S72 Figure 1Conclusion A significant proportion of our cohort met criteria for lipid-lowering therapy, but few were on appropriate treatment, suggesting potential under-recognition of CVD risk in this cohort. Challenges such as co-existing liver disease and polypharmacy may also influence prescribing practices. Given the evolving demographics and risk profiles of PwCF, further research is warranted to validate risk prediction tools and tailor cardiovascular risk management strategies for this unique cohort.