title: Clinical benefit of long-term lipoprotein apheresis in patients with severe hypercholesterolemia or Lp(a)-hyperlipoproteinemia with progressive cardiovascular disease.
abstract: Low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) are established causal risk factors for cardiovascular disease (CVD). Efficacy, safety, and tolerability of lipoprotein apheresis (LA) were investigated in 118 patients with CVD covering a period with 36,745 LA treatments in a retrospective, monocentric study. Indications for LA were severe hypercholesterolemia (n = 83) or isolated Lp(a) hyperlipoproteinemia (Lp(a)-HLP) (n = 35). In patients with hypercholesterolemia, initial pre-LA LDL-C was 176.4 ± 67.0 mg/dL. In patients with isolated Lp(a)-HLP, initial pre-LA Lp(a) was 127.2 ± 67.3 mg/dL. Mean reduction rates of LA were 67 % for both LDL-C and Lp(a). During chronic LA, the average annual rate of major adverse cardiac events of all patients declined by 79.7 % (p < 0.0001). Subgroup analysis showed decline by 73.7 % (p < 0.0001) in patients with severe hypercholesterolemia, and by 90.4 % (p < 0.0001) in patients with isolated Lp(a)-HLP. Adverse events occurred in 1.1 % of treatments. LA treatment of patients with a high risk for CVD due to hypercholesterolemia and/or Lp(a)-HLP demonstrated clinical benefit and was safe and well tolerated.
authors: Dres. Heigl, Hettich, and Partner, Medical Care Center Kempten-Allgaeu, Robert-Weixler-Straße 19, 87439, Kempten, Germany, heigl@mvz-kempten.de.
authors: Franz
authors: F
authors: Heigl
authors: Reinhard
authors: R
authors: Hettich
authors: Norbert
authors: N
authors: Lotz
authors: Harduin
authors: H
authors: Reeg
authors: Tobias
authors: T
authors: Pflederer
authors: Dirk
authors: D
authors: Osterkorn
authors: Klaus
authors: K
authors: Osterkorn
authors: Reinhard
authors: R
authors: Klingel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001781:Blood Component Removal / Q000379:methods*; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D006951:Hyperlipoproteinemias / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D017270:Lipoprotein(a) / Q000097:blood / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D017270:Lipoprotein(a)