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[Hyperlipoproteinemia and LDL apheresis. Clinical experiences with the H.E.L.P. system]
1Institut für Klinische Chemie am Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Insights
LDL-cholesterol (LDL) is a key factor in atherosclerosis and coronary heart disease (CHD). Apheresis therapies, like the H.E.L.P.-system, effectively reduce LDL and other risk factors in patients resistant to standard treatments.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Medical Technology
Context:
- High levels of low-density lipoprotein cholesterol (LDL-C) are a primary cause of atherosclerosis and coronary heart disease (CHD).
- Therapeutic guidelines aim for LDL-C levels below 100 mg/dl.
- Statins effectively lower LDL-C in most patients, reducing CHD incidence and mortality.
Purpose:
- To review the role of apheresis in managing patients with hyperlipidemia resistant to conventional therapies.
- To highlight the efficacy and safety of the H.E.L.P.-apheresis system.
Summary:
- LDL-C elevation is a major risk factor for atherosclerosis and CHD.
- While statins are effective, some patients exhibit resistance to treatment.
- Apheresis, particularly the H.E.L.P.-system, offers an effective alternative for LDL-C reduction, also removing Lp(a), Fibrinogen, and CRP.
- Clinical data show significant risk factor reduction and clinical event decrease with long-term apheresis tolerance.
Impact:
- Apheresis provides a viable therapeutic option for refractory hyperlipidemia, reducing cardiovascular risk.
- The H.E.L.P.-system demonstrates broad efficacy in removing multiple atherogenic and inflammatory markers.
- Long-term apheresis use is well-tolerated, contributing to improved patient outcomes.
Abstract:
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.