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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Prevention of acute systemic reaction during LDL apheresis post COVID-19 by icatibant pretreatment

Lauren R Davidson1, Naz Baecher1, Brian Cheung2

  • 1Department of Allergy / Immunology and Rheumatology, Department of Cardiology, University of Rochester Medical Center, Rochester, NY, USA (Davidson, Baecher, McIntosh, Bingemann, Block).

Journal of Clinical Lipidology
|May 24, 2025
PubMed

Insights

Lipoprotein apheresis can rarely cause angioedema-like reactions. Icatibant successfully prevented these severe bradykinin-induced reactions post-COVID-19 in a patient previously tolerating the treatment.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Lipoprotein apheresis effectively lowers LDL-C in familial hypercholesterolemia when medications fail.
  • This procedure can elevate bradykinin levels but is typically well-tolerated.

Observation:

  • A patient with familial hypercholesterolemia experienced angioedema-like systemic reactions after COVID-19, despite prior tolerance to lipoprotein apheresis.
  • These reactions were bradykinin-induced.

Findings:

  • The study documents the first case of such reactions occurring post-COVID-19.
  • Icatibant, a bradykinin receptor antagonist, was successfully used to prevent these reactions.

Implications:

  • This case highlights a potential complication of lipoprotein apheresis following COVID-19.
  • Icatibant may be a valuable therapeutic option for managing severe bradykinin-induced reactions to lipoprotein apheresis.

Keywords:
AngioedemaBradykininCOVID-19Familial hypercholesterolemiaGenetic lipid disordersIcatibantLDL apheresis

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