Treatment of symptomatic hyperLp(a)lipidemia with LDL-apheresis vs. usual care.
OBJECTIVE
To assess LDL-apheresis efficacy to lower Lp(a) and to compare the effects of Usual Medical Care (UMC) a 12-months study was carried out. The incidence of new coronary artery disease (CAD) events/need of revascularization, was also monitored.


METHODS
Twenty-one patients with hyperLp(a)lipidemia and angiographically documented CAD were randomly assigned to LDL-apheresis every week, or the UMC.


RESULTS
LDL-apheresis group, averaged an Lp(a) reduction of 57.8+/-9.5% vs. basal values (P<0.001). In the UMC group Lp(a) increased in 1 year to 14.7+/-36.5% (P=0.66). Stepwise multivariate regression analysis for predictors of Lp(a) including: type of treatment, smoking, hypertension, age, age at first cardiovascular event, initial Lp(a), LDL, and BMI values, was performed. Only the type of treatment was co-related (P<0.001): Lp(a) variation (beta)=0.863. The model has R2 adjusted relative risk of 0.725.


CONCLUSIONS
LDL-apheresis could be the first line treatment of isolated hyperLp(a)lipidemia when CAD is established. New CAD events/cardiac interventions were not observed.
Stefanutti
C
C
Plasmapheresis Unit, Department of Medical and Clinical Therapy, University of Rome La Sapienza, Umberto I, Hospital, Italy. plasmaferesi@tin.it
Vivenzio
A
A
Di Giacomo
S
S
Mazzarella
B
B
Ferraro
P M
PM
Abbolito
S
S
D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001781:Blood Component Removal / Q000379:methods*; D002846:Chromatography, Affinity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D018752:Diet, Fat-Restricted; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006951:Hyperlipoproteinemias / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D015994:Incidence; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D012306:Risk; D016896:Treatment Outcome
D000180:Acrylic Resins; D000924:Anticholesteremic Agents; D017270:Lipoprotein(a); C006903:carbopol 940