No question, one of the leading causal factors for early
atherosclerosis and
coronary heart disease (CHD) is the abundance of
LDL-cholesterol in the blood, exceeding limits of 100 mg/dl. Thus, recommendations for
therapy focus on
LDL-levels less than 100 mg/dl. With the introduction of the
statins--a very potent family of
lipid lowering agents--such target levels can be achieved in most of the patients, resulting in a drastic decrease of
LDL, CHD incidences, as well as in a reduction of cardiac and total mortality. There is, however, a remaining small group of patients, who is more or less resistant to an adequate combination of dietary and
drug therapy. For these patients, various techniques of
apheresis are available for over 15 years. Some of them have been approved by the FDA in the US and comparable regulatory offices in Europe. The most extensive experimental and clinical experience was gathered with the H.E.L.P.-system of B. Braun Melsungen, which differs from other
apheresis techniques by its efficiency to eliminate
LDL, Lp(a),
Fibrinogen and CRP simultaneously. The clinical results obtained up to day with the
apheresis clearly demonstrate a significant reduction of risk factors and clinical events, as well as an excellent long-term tolerance.