Like millions of other Americans, Christine Morrisey has high cholesterol. But unlike the majority of people with high cholesterol, the standard treatment — diet + exercise + statins — wasn’t working for her.
Plus, the statins were causing her muscle aches, so she stopped taking them — and her cholesterol levels kept climbing.
Fortunately, Morrisey was able to find both the cause of the problem and a potential solution at Rush's Advanced Lipid (Cholesterol) Clinic.
Getting to the heart of the matter
Morrisey came to the clinic in early 2019, and met with the clinic director, cardiologist Dinesh Kalra, MD. At that time, Morrisey’s cholesterol level was 301; the normal value is around 150. She was anxious to know was causing the extreme elevation.
After conducting a variety of tests, Kalra determined that Morrisey has a genetic disorder (known as familial hypercholesterolemia) in which one gene that metabolizes cholesterol is abnormal. All the oatmeal and cardio in the world wouldn’t have made that gene do its job properly. And if left untreated, Morrisey’s high cholesterol could have been deadly.
Kalra says that people with familial hypercholesterolemia (FH) have 4-fold higher rates of heart attacks than those who don’t have FH, even at the same cholesterol levels. The genetic abnormality exposes them to high cholesterol levels since birth, so it’s more likely their arteries will harden and narrow.
“It is important to identify the genetic cause of high cholesterol because it’s more aggressive in terms of causing fatty buildup inside the arteries,” Kalra says. “It can lead to a higher rate of heart attack, stroke or death.”
Since the statin was causing Morrisey pain, Kalra tried a different approach. He prescribed a self-injectable drug called Repatha, belonging to a class of drugs called PCSK9 inhibitors. It’s typically used for people who’ve had a heart attack or stroke, but Kalra made sure that Morrisey’s insurance was able to process the claim. PCSK9 drugs have shown efficacy in lowering bad cholesterol (LDL-C) in patients with heterozygous familial hypercholesterolemia.
The drug is expected to lower Morrisey's cholesterol levels by an impressive 60 percent. She started taking the drug this summer and will see Kalra in late-2019 for a follow-up appointment. In the meantime, she is relieved to finally feel more in control of her health.
Exploring the benefits of a ‘one-stop shop’ for patients
Kalra established the Advanced Lipid Clinic because he knows there are many people, like Morrisey, with uncontrolled high cholesterol. He describes the clinic as a “one-stop shop” for people with the following:
- Familial hypercholesterolemia and /or hypertriglyceridemia
- Family history of heart disease
- Non-statin alternatives for those with side effects or residual risk
- Low HDL cholesterol, metabolic syndrome
- High Lp(a) and genetic markers of CHD (coronary heart disease)
“What’s great about the clinic is that it allows us to prescribe other medications, besides statins, to help patients lower their cholesterol,” Kalra explains. “Patients will have opportunities to enroll in clinical trials. There’s a focus on prevention programs and dietary counseling, too.”
The clinic plans to offer an LDL apheresis service for patients with extremely high cholesterol values who don’t respond to medications alone. Apheresis uses a filtration machine that can filter out a patient’s bad lipids from their bloodstream.
Morrisey, for one, is grateful the clinic exists — and for Kalra’s expertise.
“It’s nice to know that you’re going to a cardiologist who specializes in your area of need,” she says. “Dr. Kalra is committed to doing everything he can to prevent me from having a heart attack or stroke.”