Treatment of symptomatic hyperLp(a)lipidemia with LDL-apheresis vs. usual care.

Abstract

BACKGROUND/AIMS:

To assess LDL-apheresis efficacy to lower Lp(a) and to compare the effects of Usual Medical Care (UMC) a 12-months study was carried out. The incidence of new coronary artery disease (CAD) events/need of revascularization, was also monitored.

METHODS:

Twenty-one patients with hyperLp(a)lipidemia and angiographically documented CAD were randomly assigned to LDL-apheresis every week, or the UMC.

RESULTS:

LDL-apheresis group, averaged an Lp(a) reduction of 57.8+/-9.5% vs. basal values (P<0.001). In the UMC group Lp(a) increased in 1 year to 14.7+/-36.5% (P=0.66). Stepwise multivariate regression analysis for predictors of Lp(a) including: type of treatment, smoking, hypertension, age, age at first cardiovascular event, initial Lp(a), LDL, and BMI values, was performed. Only the type of treatment was co-related (P<0.001): Lp(a) variation (beta)=0.863. The model has R2 adjusted relative risk of 0.725.

CONCLUSION:

LDL-apheresis could be the first line treatment of isolated hyperLp(a)lipidemia when CAD is established. New CAD events/cardiac interventions were not observed.

• Authors: C Stefanutti, A Vivenzio, S Di Giacomo, B Mazzarella, P M Ferraro, S Abbolito
• Journal: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis (Transfus Apher Sci) Vol. 42 Issue 1 Pg. 21-6 (Feb 2010) ISSN: 1473-0502 [Print] England
• PMID: 19932057 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: (c) 2009 Elsevier Ltd. All rights reserved.

Chemical References

• Acrylic Resins
• Anticholesteremic Agents
• Lipoprotein(a)
• carbopol 940

Topics

• Acrylic Resins
• Adult
• Aged
• Anticholesteremic Agents (therapeutic use)
• Blood Component Removal (methods)
• Chromatography, Affinity
• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging, epidemiology, etiology, therapy)
• Diet, Fat-Restricted
• Exercise Therapy
• Female
• Follow-Up Studies
• Humans
• Hyperlipoproteinemias (complications, diet therapy, drug therapy, therapy)
• Incidence
• Lipoprotein(a) (blood)
• Male
• Middle Aged
• Myocardial Revascularization (statistics & numerical data)
• Risk
• Treatment Outcome