title: [Low-density lipoprotein apheresis in familial hypercholesterolemia resistant to intensive medical treatment].
abstract: OBJECTIVE
  The aim of our study is to analyze the effect and security of low-density lipoproteins (LDL) apheresis in familial hypercholesterolemia (FH) subjects who did not response to conventional intensive optimized medical treatment.
  
  
  METHODS
  Seven heterozygous FH subjects and one homozygous apoB familial defective were studied. All subjects were on secondary prevention with highest statins doses in association with other hypolipemiant drugs; the mean LDL-C reduction was 20%. All of them were treated with LDL apheresis (immunoabsorption) for a mean of 4.25 years.
  
  
  RESULTS
  LDL apheresis resulted in a 68.3% decrease in LDL-C and 58.2% in apoB plasma values (P<.001). After an average of 3 years of follow-up, the cardiovascular events disappeared in 4 out of 5 symptomatic patients while in one patient the events were reduced in 75%. Four moderate side effects were reported in 820 apheresis procedures.
  
  
  CONCLUSIONS
  LDL apheresis is a well-tolerated and safe treatment in FH patients who do not response to intensive conventional optimized medical treatment. The main limitation is its economical cost and low accessibility.
authors.affiliation: Unidad de Aféresis, Servicio de Hematología y Oncología, Hospital Clínico Universitario de Valencia, INCLIVA, Valencia, España. arbona_cri@gva.es
authors.forename: Cristina
authors.initials: C
authors.lastname: Arbona
authors.forename: Sergio
authors.initials: S
authors.lastname: Martinez-Hervás
authors.forename: Rosa
authors.initials: R
authors.lastname: Goterris
authors.forename: Juan
authors.initials: J
authors.lastname: Montoro
authors.forename: José Tomás
authors.initials: JT
authors.lastname: Real
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Ascaso
mesh_terms: D000328:Adult; D000368:Aged; D001781:Blood Component Removal; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood* / Q000188:drug therapy / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D008077:Lipoproteins, LDL