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Lipoprotein(a) apheresis.

Sergei N Pokrovsky1, Olga I Afanasieva, Marat V Ezhov

  • 1'Russian Cardiology Research and Production Complex' of Ministry of Health of the Russian Federation, Moscow, Russia.

Current Opinion in Lipidology
|May 24, 2016
PubMed
Summary
This summary is machine-generated.

Specific lipoprotein apheresis effectively removes lipoprotein(a) [Lp(a)], reducing cardiovascular risk. Further research is needed to confirm its benefits compared to general lipoprotein apheresis systems.

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Area of Science:

  • Cardiovascular Medicine
  • Lipidology
  • Medical Technology

Background:

  • Current clinical practices involve extracorporeal elimination of atherogenic lipoprotein particles.
  • Most methods remove both lipoprotein(a) [Lp(a)] and LDL, with limited data on Lp(a) specific removal.
  • Previous studies on Lp(a) apheresis were small and non-controlled, lacking robust evidence.

Purpose of the Study:

  • To review clinical advantages of specific Lp(a) immunosorption versus other lipoprotein apheresis systems.
  • To highlight research on the efficacy of Lp(a) removal in managing cardiovascular risk.
  • To identify the need for further randomized controlled trials on specific Lp(a) apheresis.

Main Methods:

  • Review of existing literature on lipoprotein apheresis techniques.
  • Analysis of longitudinal studies and clinical trials focusing on Lp(a) and LDL reduction.
  • Examination of data from a prospective controlled clinical trial (NCT02133807) on weekly Lp(a) apheresis.

Main Results:

  • Longitudinal studies show improved cardiovascular outcomes with combined Lp(a) and LDL reduction.
  • A prospective controlled trial demonstrated regression of atherosclerosis with weekly Lp(a) removal for 18 months.
  • Existing apheresis systems often affect multiple lipoproteins, with minimal data on specific Lp(a) removal.

Conclusions:

  • Specific Lp(a) immunosorption shows promise in targeted apheresis therapy.
  • Evidence suggests potential cardiovascular benefits from specific Lp(a) removal.
  • Randomized controlled trials are essential to establish the efficacy of specific Lp(a) apheresis on cardiovascular outcomes.