High Cholesterol Often Missed in Younger Heart Surgery Patients, Tasmanian Study Finds
26 Sep 2025
The study, led by Dr Olivia Deconinck, cardiology registrar at the Royal Hobart Hospital, and Dr Andrew Black, staff cardiologist at the Royal Hobart Hospital and senior adjunct researcher at the Menzies Institute for Medical Research, was published in June in the journal Heart, Lung and Circulation.
The team reviewed 590 Tasmanian patients under 60 who had coronary artery bypass grafting (CABG) between 2008 and 2022. They found that 13.6 per cent met clinical criteria for FH — more than 30 times higher than in the general population.
“We know the importance of FH is widely under-recognised. These are people developing severe coronary disease at a young age,” said Dr Deconinck.
“What’s concerning is that very few had been diagnosed with FH prior to surgery, and most hadn’t reached recommended cholesterol targets afterwards.”
The study also found that FH patients were far less likely to reach target LDL (“bad”) cholesterol levels after surgery and were more than twice as likely to experience serious cardiovascular events, such as heart attacks, repeat procedures, or cardiac death in the following years.
“This is a missed opportunity,” said Dr Black.
“Early identification of FH allows intervention not just for the patient, but for their family too.”
FH affects about 1 in 250 Australians, many of whom remain undiagnosed. Cascade screening, where relatives of affected individuals are tested, can help detect and treat the condition early, substantially reducing the risk of heart attack.
The researchers are calling for:
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Routine FH screening in younger heart disease patients
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Stronger efforts to achieve cholesterol targets after surgery
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Greater use of therapies such as ezetimibe and PCSK9 inhibitors
Key facts from the study:
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FH affects around 100,000 Australians, but many remain undiagnosed
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13.6% of younger CABG patients had previously undetected FH
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FH patients had more than twice the rate of adverse cardiovascular events after surgery
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Only 1 in 5 FH patients achieved guideline-recommended cholesterol targets
Source: Heart, Lung and Circulation; Royal Hobart Hospital
