[Lipoprotein apheresis in patients with familial hypercholesterolemia: a single center research].

Abstract

Objective: We evaluated the safety and efficacy of lipoprotein apheresis (LA) in patients with familial hypercholesterolemia (FH) who can't reach low-density lipoprotein cholesterol(LDL-C) target goals with the maximal tolerated dose of lipid-lowering agents. Methods: This was a retrospective cross-sectional study. Between February 2015 and November 2019, patients with FH who were admitted in Fuwai hospital and treated with LA were consecutively enrolled. Based on intensive lipid-lowering agents, these patients received LA by double filtration plasma pheresis (DFPP) method. The changes of lipid levels such as LDL-C and lipoprotein(a)[Lp(a)] were compared before and after LA treatment, and the changes of immunoglobulin (Ig) concentration and LA-related adverse effects were also discussed. Results: A total of 115 patients with FH were enrolled in this study, of which 8 cases were homozygous FH and 107 cases were heterozygous FH. The age was (43.9±12.2) years and there were 75 (65.2%) males, and 108 (93.8%) with coronary artery disease. For pre-and immediately after LA treatment, the LDL-C was (5.20±2.94) mmol/L vs. (1.83±1.08) mmol/L, Lp(a) concentration was 428.70(177.00, 829.50)mg/L vs. 148.90(75.90, 317.00) mg/L (P<0.001), with a decrease of 64.2% and 59.8% respectively. The levels of IgG and IgA measured 1 day after LA treatment were both in the normal range and IgM concentration was below the reference value, the reductions of which were 15.1%, 25.0% and 58.7% respectively (P<0.001). Six patients had mild symptoms of nausea, hypotension dyspnea and palpitation, the symptoms were relieved by symptomatic treatment. Conclusion: For patients with FH who do not achieve LDL-C target goal with the maximal tolerated lipid-lowering agents, especially those with elevated Lp(a) levels, LA, which can significantly further reduce LDL-C and Lp(a) levels, is an effective and safe option.

• Authors: L Zhao, Y Gao, G Liu, C N Jia, J Zhang, Q Dong, X L Li, C G Zhu, N Q Wu, Y L Guo, J J Li
• Journal: Zhonghua xin xue guan bing za zhi (Zhonghua Xin Xue Guan Bing Za Zhi) Vol. 50 Issue 6 Pg. 585-590 (Jun 24 2022) ISSN: 0253-3758 [Print] China
• PMID: 35705468 (Publication Type: Journal Article)

Chemical References

• Cholesterol, LDL
• Lipoprotein(a)
• Lipoproteins

Topics

• Adult
• Blood Component Removal (methods)
• Cholesterol, LDL
• Cross-Sectional Studies
• Female
• Humans
• Hyperlipoproteinemia Type II (therapy)
• Lipoprotein(a) (chemistry)
• Lipoproteins (chemistry)
• Male
• Middle Aged
• Retrospective Studies