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Updated: May 7, 2026
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
Lipoprotein apheresis in patients with maximally tolerated lipid-lowering therapy,
Josef Leebmann1, Eberhard Roeseler, Ulrich Julius
11st Medical Clinic, General Hospital, Passau, Germany (J.L.); Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany (E.R.); 3rd Medical Clinic, University Hospital, Dresden, Germany (U.J.); MVZ Kempten-Allgaeu, Kempten, Germany (F.H.); Dialysis- and Lipid Center North Rhine, Essen, Germany (R.S.); Clinic for Nephrology and Dialysis, Tangermuende, Germany (D.H.); KfH-Kidney Center, Germering, Germany (P.B.); Institute of Public Health and Preventive Medicine, University Heidelberg, Mannheim, and Synlab Academy, Mannheim, and Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria (W.M.); Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany (W.L.); and Apheresis Research Institute, Cologne, Germany (A.H., R.K.).
Lipoprotein(a) (Lp(a)) hyperlipoproteinemia significantly increases cardiovascular disease risk. Chronic lipoprotein apheresis (LA) effectively reduced cardiovascular event rates in patients with progressive cardiovascular disease, even with maximal lipid-lowering therapy.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Genetics
Background:
- Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a significant, independent risk factor for cardiovascular disease (CVD).
- Lp(a) levels are genetically determined and not effectively managed by standard lipid-lowering treatments.
- Progressive CVD in patients with high Lp(a) poses a therapeutic challenge.
Purpose of the Study:
- To evaluate the impact of chronic lipoprotein apheresis (LA) on cardiovascular event incidence.
- To assess LA's efficacy in patients with progressive CVD and high Lp(a) on maximally tolerated lipid-lowering therapy.
Main Methods:
- Prospective observational multicenter study involving 170 patients with Lp(a)-hyperlipoproteinemia and progressive CVD.
- Comparison of cardiovascular event rates 2 years before and 2 years during LA treatment.
- Characterization of patients by lipid status, lipid-lowering drug treatment, and LPA gene variants.
Main Results:
- Mean annual rates of major adverse coronary events decreased significantly from 0.41 before LA to 0.09 during LA (P<0.0001).
- Overall vascular event rates also showed a significant decline from 0.61 to 0.16 (P<0.0001).
- A continuous decline in event rates was observed during the treatment period.
Conclusions:
- Lipoprotein apheresis (LA) is an effective treatment for reducing cardiovascular event incidence in patients with Lp(a)-hyperlipoproteinemia and progressive CVD.
- LA provides significant cardiovascular risk reduction when used alongside maximally tolerated lipid-lowering medications.
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