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Familial HypercholesterolaemiaSAFEHEARTNCT02693548

The Spanish Familial Hypercholesterolaemia Cohort Study

An observational study of Familial Hypercholesterolaemia, run by Fundación Hipercolesterolemia Familiar at 1 site in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

SAFEHEART is a large, on-going registry study in molecularly defined patients with heterozygous FH treated in Spain. Read more about this study

Who is it for?
Ages 15 years and olderHealthy volunteers can take part
Conditions the study is for
Familial Hypercholesterolaemia
How many people
4,141 participants
Where
1 siteSpain
Study dates
Jan 2004to Oct 2030
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: Index cases with genetic diagnosis of FH and their relatives over 15 years old with a genetic diagnosis of FH and their unaffected relatives

Who may be able to join

  • Index cases with genetic diagnosis of FH and their relatives over 15 years old with a genetic diagnosis of FH and their first-degree relatives

Who cannot join

  • Patient unwillingness

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Leopoldo Perez de Isla, MD contact

0034609084225

leopisla@hotmail.com

Spain1 site, 1 recruiting
  • Fundacion Hipercolesterolemia Familiar

    Madrid, Madrid, 28010

    Pedro Mata, MD, 0034915 570 071, fhfsecretaria@colesterolfamiliar.org

    Leopoldo Perez de Isla, MD, 0034609084225, leopisla@hotmail.com

    Recruiting

Other trials in Spain

About this study

SAFEHEART is a large, on-going registry study in molecularly defined patients with heterozygous FH treated in Spain.

Read the detailed description

Familiar hypercholesterolemia (FH) is the most common genetic disorder associated with the development of severe and premature coronary artery disease (CAD). The disorder is caused by mutations in the gene that encodes the low-density lipoprotein receptor (LDL-r), resulting in a lower expression of functional LDL-r in the liver. FH has autosomal dominant transmission with high penetrance and the prevalence of heterozygous individuals is one in 400 to 500 in the general population. To date, more than 800 different functional mutations of the LDL-r gene have been described worldwide, and more than 200 have been documented in Spain. In addition, a much less common disorder that resemble FH is familial defective apoB 100 disorder (FDB) produced by a mutation in the Apo B 100 gene. FDB accounts for a significant proportion of FH in some localized regions of Spain.

Life expectancy is shortened by 20 to 30 years in FH patients, and sudden death and myocardial infarction are the principal causes of death. The Simon Broome Register of FH in Great Britain, has shown that FH has a 100-fold increase in coronary mortality and a nearly 10-fold increase in total mortality, especially in young adults.

Since the 1990's, coronary mortality and total mortality in FH patients have decreased remarkably in part due to the use of more effective lipid-lowering therapy such as statins. The analysis of the Dutch FH cohort showed that an early treatment with statins after the diagnosis of the disorder leads to near normalisation of coronary heart disease risk comparable to the general population. Therefore, most of patients require an early, continuous and more intensive lipid-lowering therapy.

Despite the use of statins, this population still have a high risk for the development of premature CAD. Therefore, the need to study the relatives of a known FH case, know as cascade screening, is essential to detect those cases that are younger, probably with a less severe form of FH and are not receiving treatment to prevent cardiovascular disease development.

Although the genetic defect is probably the most important factor in the clinical expression of FH, other genetic (gene-gene interactions), environmental (particularly those relating to diet, tobacco consumption and physical activity) and metabolic factors could play an important role in modulating the atherosclerotic burden in this population.

To gain insight into the prognostic factors and mechanisms that influence the development of CAD and mortality in FH, a long-term prospective follow-up of a molecularly well-defined FH cohort using a multidisciplinary approach is necessary. This cohort is an excellent tool of translational research to evaluate and determine the principal prognostic factors related to CAD morbidity and mortality.

Keywords
Familial Hypercholesterolaemia, Prognosis, Cardiovascular disease
Medical subject headings
Hyperlipoproteinemia Type II, Cardiovascular Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02693548
Study groupRoleWhat they receive
Familial hypercholesterolaemia patientsIndex cases with genetic diagnosis of FH and their relatives over 15 years old with a genetic diagnosis of FH.
Unaffected relativesRelatives of FH patients without FH (genetically defined)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Prognostic assessment: time to fatal or non-fatal cardiovascular event.

    Time to first cardiovascular event: fatal or non-fatal myocardial infarction, fatal or non-fatal ischemic stroke, coronary revascularization, peripheral artery revascularization, aortic valve replacement or cardiovascular death.

    Measured: up to 12 years

Secondary outcomes (1)
  1. LDL-cholesterol level (mg/dl) at entry and at follow-up

    LDL-cholesterol measurement at enrolment and after follow-up. At enrolment, a central core lab is in charge of the analysis. During follow-up, a yearly-based phone call is used to contact every subject and a complete lipid profile is obtained from the patient (obtained in his/her usual medical care).

    Measured: up to12 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Feb 2016 (estimated)
  2. Study startJan 2004
  3. Primary completionOct 2030 (estimated)
  4. Study completionOct 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
4,141 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02693548
Sponsor's protocol ID
SAFEHEART
Acronym
SAFEHEART
Status last verified
Sep 2026
First submitted
9 Feb 2016
Last updated
4 Sep 2026
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Undecided: Available access for publication

Publications

  • Vallejo-Vaz AJ, Kondapally Seshasai SR, Cole D, Hovingh GK, Kastelein JJ, Mata P, Raal FJ, Santos RD, Soran H, Watts GF, Abifadel M, Aguilar-Salinas CA, Akram A, Alnouri F, Alonso R, Al-Rasadi K, Banach M, Bogsrud MP, Bourbon M, Bruckert E, Car J, Corral P, Descamps O, Dieplinger H, Durst R, Freiberger T, Gaspar IM, Genest J, Harada-Shiba M, Jiang L, Kayikcioglu M, Lam CS, Latkovskis G, Laufs U, Liberopoulos E, Nilsson L, Nordestgaard BG, O'Donoghue JM, Sahebkar A, Schunkert H, Shehab A, Stoll M, Su TC, Susekov A, Widen E, Catapano AL, Ray KK. Familial hypercholesterolaemia: A global call to arms. Atherosclerosis. 2015 Nov;243(1):257-9. doi: 10.1016/j.atherosclerosis.2015.09.021. Epub 2015 Sep 18. No abstract available.

    PubMed 26408930
  • Fuentes F, Alcala-Diaz JF, Watts GF, Alonso R, Muniz O, Diaz-Diaz JL, Mata N, Sanchez Munoz-Torrero JF, Brea A, Galiana J, Figueras R, Aguado R, Piedecausa M, Cepeda JM, Vidal JI, Rodriguez-Cantalejo F, Lopez-Miranda J, Mata P; SAFEHEART Investigators. Statins do not increase the risk of developing type 2 diabetes in familial hypercholesterolemia: The SAFEHEART study. Int J Cardiol. 2015 Dec 15;201:79-84. doi: 10.1016/j.ijcard.2015.07.107. Epub 2015 Aug 5.

    PubMed 26296047
  • Alonso R, Andres E, Mata N, Fuentes-Jimenez F, Badimon L, Lopez-Miranda J, Padro T, Muniz O, Diaz-Diaz JL, Mauri M, Ordovas JM, Mata P; SAFEHEART Investigators. Lipoprotein(a) levels in familial hypercholesterolemia: an important predictor of cardiovascular disease independent of the type of LDL receptor mutation. J Am Coll Cardiol. 2014 May 20;63(19):1982-9. doi: 10.1016/j.jacc.2014.01.063. Epub 2014 Mar 13.

    PubMed 24632281
  • Alonso R, Mata P, Zambon D, Mata N, Fuentes-Jimenez F. Early diagnosis and treatment of familial hypercholesterolemia: improving patient outcomes. Expert Rev Cardiovasc Ther. 2013 Mar;11(3):327-42. doi: 10.1586/erc.13.7.

    PubMed 23469913
  • Aledo R, Alonso R, Mata P, Llorente-Cortes V, Padro T, Badimon L. LRP1 gene polymorphisms are associated with premature risk of cardiovascular disease in patients with familial hypercholesterolemia. Rev Esp Cardiol (Engl Ed). 2012 Sep;65(9):807-12. doi: 10.1016/j.recesp.2012.03.013. Epub 2012 Jul 20. English, Spanish.

    PubMed 22819221
  • Vazquez C, Alonso R, Garriga M, de Cos A, de la Cruz JJ, Fuentes-Jimenez F, Salas-Salvado J, Mata P. Validation of a food frequency questionnaire in Spanish patients with familial hypercholesterolaemia. Nutr Metab Cardiovasc Dis. 2012 Oct;22(10):836-42. doi: 10.1016/j.numecd.2011.01.007. Epub 2011 Jun 23.

    PubMed 21703832
  • Mata N, Alonso R, Badimon L, Padro T, Fuentes F, Muniz O, Perez-Jimenez F, Lopez-Miranda J, Diaz JL, Vidal JI, Barba A, Piedecausa M, Sanchez JF, Irigoyen L, Guallar E, Ordovas JM, Mata P. Clinical characteristics and evaluation of LDL-cholesterol treatment of the Spanish Familial Hypercholesterolemia Longitudinal Cohort Study (SAFEHEART). Lipids Health Dis. 2011 Jun 10;10:94. doi: 10.1186/1476-511X-10-94.

    PubMed 21663647
  • Criado-Garcia J, Fuentes F, Cruz-Teno C, Garcia-Rios A, Jimenez-Morales A, Delgado-Lista J, Mata P, Alonso R, Lopez-Miranda J, Perez-Jimenez F; Spanish Group for the Study of Familiar Hypercholesterolemia. R353Q polymorphism in the factor VII gene and cardiovascular risk in Heterozygous Familial Hypercholesterolemia: a case-control study. Lipids Health Dis. 2011 Apr 9;10:50. doi: 10.1186/1476-511X-10-50.

    PubMed 21477332
  • Garcia-Rios A, Perez-Martinez P, Mata P, Fuentes F, Lopez-Miranda J, Alonso R, Caballero J, Mata N, Perez-Jimenez F, Ordovas JM. Polymorphism at the TRIB1 gene modulates plasma lipid levels: insight from the Spanish familial hypercholesterolemia cohort study. Nutr Metab Cardiovasc Dis. 2011 Dec;21(12):957-63. doi: 10.1016/j.numecd.2010.04.002. Epub 2010 Aug 6.

    PubMed 20692138
  • Zambon D, Quintana M, Mata P, Alonso R, Benavent J, Cruz-Sanchez F, Gich J, Pocovi M, Civeira F, Capurro S, Bachman D, Sambamurti K, Nicholas J, Pappolla MA. Higher incidence of mild cognitive impairment in familial hypercholesterolemia. Am J Med. 2010 Mar;123(3):267-74. doi: 10.1016/j.amjmed.2009.08.015.

    PubMed 20193836
  • Garcia-Rios A, Perez-Martinez P, Fuentes F, Mata P, Lopez-Miranda J, Alonso R, Rodriguez F, Garcia-Olid A, Ruano J, Ordovas JM, Perez-Jimenez F. Genetic variations at ABCG5/G8 genes modulate plasma lipids concentrations in patients with familial hypercholesterolemia. Atherosclerosis. 2010 Jun;210(2):486-92. doi: 10.1016/j.atherosclerosis.2010.01.010. Epub 2010 Jan 22.

    PubMed 20172523
  • Alonso R, Defesche JC, Tejedor D, Castillo S, Stef M, Mata N, Gomez-Enterria P, Martinez-Faedo C, Forga L, Mata P. Genetic diagnosis of familial hypercholesterolemia using a DNA-array based platform. Clin Biochem. 2009 Jun;42(9):899-903. doi: 10.1016/j.clinbiochem.2009.01.017. Epub 2009 Feb 6.

    PubMed 19318025
  • Alonso R, Mata N, Castillo S, Fuentes F, Saenz P, Muniz O, Galiana J, Figueras R, Diaz JL, Gomez-Enterria P, Mauri M, Piedecausa M, Irigoyen L, Aguado R, Mata P; Spanish Familial Hypercholesterolaemia Group. Cardiovascular disease in familial hypercholesterolaemia: influence of low-density lipoprotein receptor mutation type and classic risk factors. Atherosclerosis. 2008 Oct;200(2):315-21. doi: 10.1016/j.atherosclerosis.2007.12.024. Epub 2008 Feb 20.

    PubMed 18243212
  • Merino-Ibarra E, Castillo S, Mozas P, Cenarro A, Martorell E, Diaz JL, Suarez-Tembra M, Alonso R, Civeira F, Mata P, Pocovi M; Spanish Group of Familial Hypercholesterolemia. Screening of APOB gene mutations in subjects with clinical diagnosis of familial hypercholesterolemia. Hum Biol. 2005 Oct;77(5):663-73.

    PubMed 16596945
  • Civeira F, Castillo S, Alonso R, Merino-Ibarra E, Cenarro A, Artied M, Martin-Fuentes P, Ros E, Pocovi M, Mata P; Spanish Familial Hypercholesterolemia Group. Tendon xanthomas in familial hypercholesterolemia are associated with cardiovascular risk independently of the low-density lipoprotein receptor gene mutation. Arterioscler Thromb Vasc Biol. 2005 Sep;25(9):1960-5. doi: 10.1161/01.ATV.0000177811.14176.2b. Epub 2005 Jul 14.

    PubMed 16020744

Questions about this trial

What is this clinical trial studying?

An observational study of Familial Hypercholesterolaemia, run by Fundación Hipercolesterolemia Familiar at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 4 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Pedro Mata, MD (0034915570071, pmata@colesterolfamiliar.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prognostic assessment: time to fatal or non-fatal cardiovascular event. (time frame: up to 12 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02693548, which also lists 30 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Sep 2026.

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