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Effect of specific lipoprotein(a) apheresis on coronary atherosclerosis regression assessed by quantitative coronary

Maya S Safarova1, Marat V Ezhov, Olga I Afanasieva

  • 1Cardiology Research Center 15A, 3rd Cherepkovskaya Street, 121552 Moscow, Russia. Dr.Safarova@gmail.com

Atherosclerosis. Supplements
|January 30, 2013
PubMed

Insights

Specific lipoprotein(a) [Lp(a)] apheresis significantly reduced coronary atherosclerosis in patients with coronary heart disease. This Lp(a) lowering therapy demonstrated greater efficacy than atorvastatin alone.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Lipid Metabolism

Background:

  • Elevated lipoprotein(a) [Lp(a)] is a risk factor for coronary heart disease (CHD).
  • Specific Lp(a) apheresis aims to reduce cardiovascular events by lowering Lp(a) levels.

Purpose of the Study:

  • To evaluate the impact of specific Lp(a) apheresis on coronary atherosclerosis progression.
  • To compare the efficacy of Lp(a) apheresis versus atorvastatin in CHD patients with elevated Lp(a).

Main Methods:

  • Prospective study of 30 CHD patients with elevated Lp(a) and LDL-C on statins.
  • Randomized allocation to weekly Lp(a) apheresis (n=15) or atorvastatin only (n=15) for 18 months.
  • Quantitative coronary angiography assessed percent diameter stenosis and minimal lumen diameter (MLD).

Main Results:

  • Lp(a) apheresis reduced Lp(a) by 73% and Lp(a)-corrected LDL-C by 7%.
  • Median percent diameter stenosis decreased with apheresis (-2.0%) versus increased with atorvastatin (3.5%).
  • Apheresis showed a more favorable effect on MLD (0.20 mm vs 0.01 mm) and higher rates of coronary segment regression/stabilization.

Conclusions:

  • Specific Lp(a) apheresis promotes coronary atherosclerosis regression in stable CHD patients.
  • This apheresis therapy effectively lowers Lp(a) and helps achieve LDL-C goals.
  • Lp(a) apheresis is a promising therapeutic option for managing high Lp(a) in CHD.
Abstract

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