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Role of Lipoprotein Apheresis in Cardiovascular Disease Risk Reduction
Rupesh Raina1,2, Claire Young3, Vinod Krishnappa4,5
1Department of Nephrology, Cleveland Clinic Akron General and Akron Children's Hospital, Akron, Ohio, USA, rraina@akronchildrens.org.
Insights
Lipoprotein apheresis (LA) effectively lowers lipid levels and reduces cardiovascular events in patients unresponsive to standard treatments. This safe therapy may be considered for managing hypercholesterolemia and preventing future cardiovascular disease (CVD).
Area of Science:
- Cardiology
- Biochemistry
Background:
- Elevated low-density lipoprotein cholesterol and lipoprotein(a) are key risk factors for cardiovascular disease (CVD).
- Current hypercholesterolemia management includes statins and PCSK9 inhibitors.
- Lipoprotein apheresis (LA) is used for familial hypercholesterolemia (FH) but not standard for non-FH patients.
Purpose of the Study:
- To review the literature on the efficacy of lipoprotein apheresis (LA) in cardiovascular disease (CVD) prevention.
- To evaluate LA as a therapeutic option for hypercholesterolemia management.
Main Methods:
- A literature search was conducted on PubMed/MEDLINE.
- Keywords used were "LA" and "CVD".
- Relevant citations were reviewed.
Main Results:
- Evidence from observational studies demonstrates LA's efficacy.
- LA effectively reduces serum lipoprotein levels.
- LA reduces adverse cardiovascular events in patients unresponsive to lipid-lowering medications.
Conclusions:
- Lipoprotein apheresis (LA) is a safe and effective therapy for hypercholesterolemia.
- LA can be considered for managing hypercholesterolemia and reducing future CVD risk.
- Randomized controlled trials are needed to further support LA's role.
Background And Aim:
Elevated low-density lipoprotein cholesterol and/or lipoprotein(a) are established risk factors for cardiovascular disease (CVD). Management of hypercholesterolemia consists of drug therapies, including statins and proprotein convertase subtilisin/kexin type 9 inhibitors. In patients with familial hypercholesterolemia (FH), lipoprotein apheresis (LA) is utilized to control lipid levels. However, LA is not currently a standard therapy for non-FH. This review summarizes the literature regarding LA therapy in CVD prevention.
Methods:
PubMed/MEDLINE databases were searched using the keywords "LA" and "CVD". Citations were individually reviewed for relevance.
Results:
The efficacy of LA was clearly demonstrated, largely based on evidence from observational studies. In patients who are unresponsive to traditional lipid-lowering medications, LA effectively reduced serum lipoprotein levels and adverse cardiovascular events.
Conclusion:
It was concluded that LA is a safe and effective technique that could be considered in the management of hypercholesterolemia and future risk. Randomized control trials would further support a role for LA as a therapeutic option.
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