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[Selection criteria for treatment of severe hyperlipoproteinemias with LDL apheresis].

Abstract
LDL (low density lipoprotein) - apheresis has been established as an alternative management of severe hypercholesterolaemia after failure of conventional diet and drug therapy. General indication criteria for LDL-apheresis have yet been established. Indication guidelines in USA, Europe and japan are based on whether coronary heart disease is present and on the degree of lDL cholesterol elevation after treatment with diet and maximal drug therapy. It is reasonable to consider LDL apheresis therapy for: 1. patient with coronary heart disease and LDL cholesterol 4.9 mmol/l (190 mg/dl); 2. patients without coronary heart disease, but at high risk for disease (due to an LDL cholesterol above 6.4 mmol/l (250 mg/dl), a first-degree relative with premature coronary heart disease, and the presence of one or more additional risk factor. The therapeutical goal with present coronary heart disease is lDL cholesterol less than 3.4 mmol/l (130 mg/dl), with asymptomatic coronary heart less than 5.2 mmol/l (200 mg/dl). In addition, LDL apheresis is recommended for the management of all patients with homozygous familial hypercholesterolaemia due to the very high risk of coronary heart disease and the poor response to usual lipid-lowering treatments. In the end present two typical cases, treated by LDL-apheresis.
AuthorsV Bláha, Z Zadák, M Bláha, E Havel, D Solichová, M Brátová, J Malý, L Kmonícek
JournalCasopis lekaru ceskych (Cas Lek Cesk) Vol. 137 Issue 14 Pg. 424-9 (Jul 13 1998) ISSN: 0008-7335 [Print] Czech Republic
Vernacular TitleSelekcní kritéria k léc bĕ závazných hyperlipoproteinémií metodou LDL aferéz.
PMID9748737 (Publication Type: Case Reports, English Abstract, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cholesterol, LDL
Topics
  • Adolescent
  • Adult
  • Blood Component Removal
  • Cholesterol, LDL (blood)
  • Female
  • Humans
  • Hyperlipoproteinemia Type II (blood, complications, therapy)
  • Male
  • Middle Aged
  • Myocardial Ischemia (complications)

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