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The impact of lipid apheresis on changes of lipoprotein(a): a systematic review and meta-analysis
Bahman Razi1, Masoud Eslami2, Saeed Aslani3
1Department of Laboratory Sciences and Hematology, School of Allied Medical Science, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Insights
Lipid apheresis therapy significantly reduces elevated lipoprotein(a) [Lp(a)] levels, a key risk factor for cardiovascular diseases. This meta-analysis confirms its effectiveness across diverse patient groups and treatment methods.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Clinical Research
Background:
- Elevated lipoprotein(a) [Lp(a)] is a recognized independent risk factor for cardiovascular diseases (CVDs).
- Understanding effective interventions for managing high Lp(a) is crucial for CVD prevention.
- Lipid apheresis is a potential therapeutic option for lowering Lp(a).
Purpose of the Study:
- To systematically review and meta-analyze the impact of lipid apheresis therapy on serum Lp(a) levels.
- To evaluate the efficacy of lipid apheresis in various patient populations and disease contexts, particularly CVDs.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched PubMed, Scopus, and Web of Science databases up to May 2025.
- Included 67 studies with 2466 participants, analyzing pre- and post-treatment Lp(a) levels using a random-effects model.
Main Results:
- Lipid apheresis therapy demonstrated a significant reduction in serum Lp(a) levels (SMD = -1.52; P < 0.001).
- Significant reductions were observed across different Lp(a) detection methods, disease backgrounds, and initial Lp(a) levels.
- Even single-session lipid apheresis showed significant Lp(a) reduction (SMD = -1.51; P < 0.001).
Conclusions:
- Lipid apheresis is an effective treatment for significantly lowering serum Lp(a) concentrations.
- The findings support the therapeutic role of lipid apheresis in managing elevated Lp(a) and potentially mitigating cardiovascular risk.
- Treatment efficacy is consistent across various patient groups and apheresis modalities.
Aims:
Elevated levels of lipoprotein(a) [Lp(a)] are increasingly recognized as an independent risk factor for cardiovascular diseases (CVDs). This systematic review and meta-analysis aimed to evaluate the impact of lipid apheresis therapy on serum Lp(a) levels in a wide array of disorders, particularly CVDs.
Methods And Results:
Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases up to May 2025. Studies reporting pre- and post-treatment Lp(a) levels in participants undergoing lipid apheresis were included. A random-effects model was used when heterogeneity was significant. Subgroup and meta-regression analyses were conducted to explore potential sources of heterogeneity. A total of 43 publications comprising 67 studies with 2466 participants were analysed. Lipid apheresis significantly reduced serum Lp(a) levels (SMD = -1.52; 95% CI = -1.76 to -1.29; P < 0.001). Subgroup analyses confirmed significant reductions across various methods of Lp(a) detection, disease backgrounds, and initial Lp(a) levels. One-session lipid apheresis studies (n = 6) also demonstrated a significant reduction (SMD = -1.51; 95% CI = -1.72 to -1.29; P < 0.001). Meta-regression suggested that publication year and disease background contributed to heterogeneity.
Conclusion:
Lipid apheresis is effective in significantly lowering serum Lp(a) concentrations across a range of patient groups and treatment modalities. These findings support the therapeutic role of lipid apheresis in managing elevated Lp(a).
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