[Discrete plasmapheresis for coronary heart disease]

Area of Science:

• Cardiovascular Medicine
• Therapeutic Apheresis
• Internal Medicine

Background:

• Coronary heart disease (CHD) presents complex challenges in managing homeostatic dysregulation.
• Current therapeutic strategies for CHD require continuous evaluation for enhanced efficacy.
• Understanding the impact of apheresis on systemic homeostasis is crucial for treatment optimization.

Purpose of the Study:

• To establish the rationale for using discrete plasmapheresis (PA) as an efficient therapeutic intervention for CHD.
• To evaluate the expediency and effectiveness of low-volume PA within a comprehensive CHD treatment package.

Main Methods:

• Conducted 120 cycles of low-volume therapeutic PA, totaling 585 sessions, in 91 patients diagnosed with CHD.
• Monitored key parameters including blood lipid composition, hemocoagulation, rheology, and endotoxicosis.
• Assessed the impact of plasma volume removal on homeostatic markers.

Main Results:

• Complete removal of circulating plasma volume per treatment cycle significantly improved abnormally elevated homeostatic parameters.
• Key beneficial changes were observed in parameters related to lipid metabolism, coagulation, and systemic inflammation.
• Crucially, levels of high-density lipoprotein cholesterol, antithrombin III, and albumin remained stable, indicating targeted and safe plasma component management.

Conclusions:

• Low-volume discrete PA is a pathogenetically justified and effective method for modulating homeostasis in patients with CHD.
• This therapeutic approach offers a significant advancement in managing the complex pathophysiology of coronary heart disease.
• The findings support the integration of low-volume PA into the therapeutic armamentarium for CHD.