title: Lipoprotein apheresis results in plaque stabilization and prevention of cardiovascular events: comments on the prospective Pro(a)LiFe study.
abstract: Elevated lipoprotein(a) (Lp(a)) has emerged as an important independent cardiovascular risk factor, and causal association has been accepted with adverse outcome in atherosclerotic disease. Lipoprotein apheresis (LA) can lower low-density lipoprotein (LDL)-cholesterol and Lp(a) by 60-70 % and is the final escalating therapeutic option in patients with hyperlipoproteinemias (HLP) involving LDL or Lp(a) particles. Major therapeutic effect of LA is preventing cardiovascular events. Stabilizing plaque morphology might be an important underlying mechanism of action. In Germany, since 2008, a reimbursement guideline has been implemented to establish the indication for LA not only for familial or severe forms of hypercholesterolemia but also for Lp(a)-HLP associated with a progressive course of cardiovascular disease, that persists despite effective treatment of other concomitant cardiovascular risk factors, i.e. isolated Lp(a)-HLP. The Pro(a)LiFe-study confirmed with a prospective multicenter design that LA can effectively reduce Lp(a) plasma levels and prevent cardiovascular events.
authors: Apheresis Research Institute, Stadtwaldgürtel 77, 50935, Cologne, Germany, afi@apheresis-research.org.
authors: Reinhard
authors: R
authors: Klingel
authors: Andreas
authors: A
authors: Heibges
authors: Cordula
authors: C
authors: Fassbender
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000209:etiology / Q000517:prevention & control*; D001781:Blood Component Removal / Q000379:methods*; D005260:Female; D005858:Germany; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood* / Q000150:complications / Q000628:therapy*; D017270:Lipoprotein(a) / Q000097:blood / Q000302:isolation & purification*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016896:Treatment Outcome
chemical_list: D017270:Lipoprotein(a)
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