Article ID Journal Published Year Pages File Type
2895682 Atherosclerosis Supplements 2009 6 Pages PDF
Abstract

LDL-apheresis (LDLa) efficacy in the treatment of symptomatic HyperLp(a)lipoproteinemia -HyperLp(a)- has been studied in a multicentre trial. After 3.1±2.7 years of weekly and biweekly treatment, the data from 19 patients (males:12; females:7; aged 53.8±9.3 years; mean body mass index: 24.6±2.3 Kg/m2) were evaluated. Data were collected using the same questionnaire shared by 5 participating centres. A total of 2331 procedures were performed. A mean of 3593.7±800.3 ml of plasma or 8115.3±2150.1 ml of blood, depending upon the technique used (H.E.L.P., D.A.LI., Dextransulphate, Lipocollect 200), was regularly treated on average every 10.1±2.6 days. Baseline mean Lp(a) levels were 172.3±153.8 mg/dL. The mean pre-/post-apheresis Lp(a) levels decreased from 124.5±107.2 mg/dL (p<0.001 vs baseline) to 34.2±40.6 mg/dL (p<0.001 vs pre-). Baseline mean LDL-cholesterol (LDLC) levels were 152.3±74.6 mg/dL. The mean pre-/post-apheresis LDLC levels decreased from 130.4±61.1 mg/dL (p<0.004 vs baseline) to 41.2±25.1 mg/dL (p<0.001 vs pre-). The hypolipidemic drugs given to the patients during LDLa were: ezetimibe+simvastatin, atorvastatin, rosuvastatin, pravastatin, acipimox, and ω-3 fatty acids. 58% of the patients had arterial hypertension. Cigarette smokers were 5.3%. Alcohol intake was present in 21%. 52.6% were physically active. Patients with coronary artery disease (CAD) submitted to coronary catheterization before LDLa were 95%. In 5.5% (#1) CAD recurred despite treatment with LDLa. 79% were submitted to coronary revascularization before LDLa. CAD was: monovasal in 8 patients (42.1%), bivasal in 5 (26.4%), trivasal in 4 (21%), plurivasal in 2 (10.5%). In 94.5% of the sample the lesions were stable (< 0% deviation) over 3.1±2.7 years. 37% had both CAD and extra-coronary artery disease. This multicentre study confirmed that long-term treatment with LDLa was at least able to stabilize CAD in the majority of the individuals with symptomatic HyperLp(a).

Related Topics
Health Sciences Medicine and Dentistry Cardiology and Cardiovascular Medicine