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[Reducing low density lipoprotein-cholesterol levels by apheresis]

I Reiber1, A Gógl

  • 1Szent György Kórház, Székesfehérvár, I. Belgyógyászat.

Orvosi Hetilap
|March 13, 1994
PubMed
Summary

For familial hypercholesterolemia patients resistant to diet and drugs, lipoprotein apheresis offers a vital treatment. This procedure effectively lowers LDL cholesterol and other atherogenic factors, improving patient outcomes.

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Area of Science:

  • Cardiology
  • Metabolic Disorders
  • Biochemistry

Context:

  • Familial hypercholesterolemia (FH) presents a significant challenge, with many patients exhibiting resistance to conventional diet and pharmacotherapy.
  • Approximately 20% of FH heterozygotes and a predominant number of homozygotes do not respond adequately to lipid-lowering treatments, even with multiple drugs.

Purpose:

  • To review and analyze various lipoprotein apheresis procedures for managing lipid-lowering resistant familial hypercholesterolemia.
  • To evaluate the selectivity, advantages, disadvantages, and costs associated with different apheresis techniques.

Summary:

  • Lipoprotein apheresis is indicated for both absolute (homozygotes) and relative (heterozygotes) cases of FH.
  • Combining apheresis with diet and drugs can achieve maximal low-density lipoprotein-cholesterol reduction (60-70%).
  • Apheresis can also remove lipoprotein(a) and fibrinogen, improving hemorheological status.

Impact:

  • Provides a crucial alternative treatment for patients with severe or drug-resistant hypercholesterolemia.
  • Offers a method to reduce atherogenic factors beyond LDL-cholesterol, potentially mitigating cardiovascular risk.
  • Aids clinicians in selecting the most appropriate and cost-effective apheresis strategy for individual patients.

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