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Lipoprotein (a) and coronary heart disease - is there an efficient secondary prevention?

Klaus-Peter Mellwig1, Dieter Horstkotte2, Frank van Buuren2

  • 1Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany. kpmellwig@hdz-nrw.de.

Clinical Research in Cardiology Supplements
|February 25, 2017
PubMed

Insights

Lipid apheresis effectively reduces cardiovascular events in patients with high Lipoprotein (a) and coronary heart disease. This treatment significantly lowered the need for further percutaneous coronary interventions (PCI).

Area of Science:

  • Cardiology
  • Lipidology
  • Interventional Cardiology

Background:

  • Lipoprotein (a) [Lp(a)] is a significant risk factor for cardiovascular diseases, particularly coronary heart disease (CHD).
  • Elevated Lp(a) levels, often alongside hyperlipoproteinaemia, are linked to increased CHD development and progression.

Purpose of the Study:

  • To evaluate the effectiveness of lipid apheresis in patients with high Lp(a) and established coronary heart disease (CHD).
  • To assess the impact of lipid apheresis on the need for subsequent percutaneous coronary interventions (PCI) in this patient group.

Main Methods:

  • A retrospective, single-center observational study was conducted.
  • Patients with angiographically documented CHD, elevated LDL cholesterol, and high Lp(a) underwent weekly lipid apheresis.
  • Data on prior and subsequent PCI and coronary artery bypass grafting (CABG) procedures were analyzed.

Main Results:

  • Following lipid apheresis, mean Lp(a) decreased from 133.04 ± 39.68 mg/dl to 91.13 ± 33.02 mg/dl.
  • Mean LDL cholesterol also decreased from 144.39 ± 92.01 mg/dl to 99.43 ± 36.53 mg/dl.
  • The incidence of PCI was reduced by 71.43% during the follow-up period (median 51 months).

Conclusions:

  • Lipid apheresis is an effective treatment for reducing cardiovascular risk in patients with high Lp(a) and CHD.
  • This therapy significantly decreases the need for repeat revascularization procedures like PCI.
  • Lipid apheresis offers a valuable therapeutic option for managing complex cardiovascular disease driven by elevated Lp(a).

Keywords:
Acute coronary syndromeCoronary heart disease (CHD)InterventionLipid apheresisLipoprotein (a)Lp (a)Prevention

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