title: Quality of life in patients treated with lipoprotein apheresis.
abstract: OBJECTIVE
  Elevated levels of low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) [Lp(a)] are known risk factors for atherosclerosis and cardiovascular events. Although lipoprotein apheresis (LA) yields optimal outcomes for patients suffering from progressive cardiovascular disease (CVD; coronary, peripheral, and cerebrovascular arterial disease) in the presence of hyperlipoproteinemia (LDL-C > 100 mg/dL or Lp(a) > 60 mg/dL), LA primarily serves as a "last-resort therapy". Extant findings show that the incidence of new cardiovascular events can be reduced by regular LA. However, it remains unclear whether improvements to the quality of life (QOL) improvement produced by the positive impact on the course of cardiovascular disease outweighs the therapy's time consuming and invasive character. We surveyed 36 patients (32 men and 4 women; age 53 ± 13 years [mean + standard deviation]) undergoing regular LA therapy to assess the effects of apheresis on QOL.
  
  
  METHODS
  QOL was evaluated in 29 patients on regular lipoprotein apheresis treatment using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), the Beck Depression Inventory (BDI), and a newly developed questionnaire for assessing QOL in patients undergoing LA.
  
  
  RESULTS
  Patients treated with LA showed lower QOL scores regarding mental aspects and equal scores regarding physical aspects compared to the general population, analogue to the results of patients on hemodialysis (SF-36). Analysis of BDI scores showed apheresis patients did not meet criteria for depression diagnosis, although their depression scores were higher than the general population. Compared to the pre-apheresis period, patients described an improvement of their physical and mental fitness, less angina pectoris and no treatment related pain were reported (apheresis questionnaire).
  
  
  CONCLUSIONS
  Apheresis treatment appears to reduce the subjective physical complaints of patients. The partly impaired mental health in patients undergoing apheresis may be attributed to the underlying severe cardiovascular disease. The procedure itself is generally tolerated without major complaints, suggesting the benefits of apheresis exceed any negative effects on patient QOL.
authors.affiliation: Interdisziplinäres Stoffwechsel-Centrum, Lipidambulanz, Charité Berlin, Berlin, Germany. Electronic address: adrian.rosada@charite.de.
authors.forename: Adrian
authors.initials: A
authors.lastname: Rosada
authors.affiliation: Interdisziplinäres Stoffwechsel-Centrum, Lipidambulanz, Charité Berlin, Berlin, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kassner
authors.affiliation: Vivantes Klinikum im Friedrichshain, Berlin, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Banisch
authors.affiliation: Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bender
authors.affiliation: Interdisziplinäres Stoffwechsel-Centrum, Lipidambulanz, Charité Berlin, Berlin, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Steinhagen-Thiessen
authors.affiliation: Stoffwechselambulanz, Medizinische Klinik und Poliklinik IV, Klinikum der Universität, München, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Vogt
mesh_terms: D000328:Adult; D000368:Aged; D001781:Blood Component Removal; D003863:Depression / Q000175:diagnosis; D005260:Female; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood / Q000523:psychology / Q000628:therapy; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008074:Lipoproteins
keywords: Cardiovascular disease; Hypercholesterolemia; Lipoprotein apheresis; Quality of life