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Three low density lipoprotein apheresis techniques in treatment of patients with familial hypercholesterolemia: a

W O Richter1, M G Donner, P Schwandt

  • 1Medical Department II, Ludwig-Maximilians-University of Munich, Klinikum Grosshadern, Germany.

Therapeutic Apheresis : Official Journal of the International Society for Apheresis and the Japanese Society for Apheresis
|July 31, 1999
PubMed

Insights

Low density lipoprotein (LDL) apheresis effectively stabilizes coronary atherosclerosis in patients with severe hypercholesterolemia. This lipid-lowering treatment demonstrated comparable results across multiple apheresis techniques, halting disease progression in most cases.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Metabolic Disorders

Background:

  • Severe hypercholesterolemia poses significant cardiovascular risk.
  • Drug treatment is often insufficient for advanced cases.
  • Coronary heart disease necessitates aggressive lipid management.

Purpose of the Study:

  • To evaluate the long-term efficacy of LDL apheresis in stabilizing coronary atherosclerosis.
  • To compare outcomes across different LDL apheresis techniques.
  • To assess the impact on lipid profiles and cardiovascular events.

Main Methods:

  • Longitudinal study of 34 patients undergoing LDL apheresis (immunoadsorption, HELP, dextran sulfate).
  • Treatment duration averaged 4.6 years.
  • Coronary angiograms assessed lesion progression/regression; lipid levels and adverse events were monitored.

Main Results:

  • All apheresis methods showed comparable effects on LDL cholesterol, HDL cholesterol, and lipoprotein (a).
  • Coronary lesion regression observed in 3 patients; progression halted in others.
  • No severe side effects reported; bypass graft patency was high.

Conclusions:

  • Aggressive lipid lowering via LDL apheresis is effective in stabilizing coronary atherosclerosis.
  • LDL apheresis offers a viable treatment option for refractory hypercholesterolemia.
  • Long-term apheresis can prevent further atherosclerotic progression and maintain graft patency.

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