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Extracorporeal immunoadsorption for the specific removal of lipoprotein (a) (Lp(a) apheresis): preliminary clinical
S N Pokrovsky1, A V Sussekov, O I Afanasieva
1Institute of Experimental Cardiology, Cardiology Research Center, Moscow, Russia.
Insights
Lipoprotein (a) apheresis effectively removed up to 88% of Lp(a) in patients with coronary artery disease. This extracorporeal treatment showed no significant side effects, offering a specific method for lowering Lp(a) levels.
Area of Science:
- Cardiovascular Medicine
- Lipidology
- Medical Technology
Background:
- Coronary artery disease (CAD) is a significant health concern.
- Elevated lipoprotein (a) [Lp(a)] is a risk factor for CAD.
- Current treatments for CAD may not adequately address Lp(a) risk.
Purpose of the Study:
- To evaluate the efficacy and safety of Lp(a) apheresis in patients with CAD.
- To assess the impact of Lp(a) apheresis on Lp(a) levels and other plasma lipids.
- To determine the specificity of Lp(a) apheresis in removing Lp(a).
Main Methods:
- Extracorporeal Lp(a) apheresis was performed on three patients with documented CAD.
- A total of 168 procedures were conducted.
- Plasma levels of Lp(a), LDL cholesterol, and plasminogen were monitored.
Main Results:
- Lp(a) apheresis reduced Lp(a) levels by up to 88%.
- The procedure was well-tolerated with no significant side effects observed.
- Levels of LDL cholesterol and plasminogen remained largely unchanged, indicating specificity.
Conclusions:
- Lp(a) apheresis is a unique, effective, and specific method for reducing Lp(a) levels.
- The treatment appears safe for patients with CAD.
- Further clinical trials are necessary to ascertain the long-term clinical benefits of Lp(a) apheresis.
Abstract:
The extracorporeal procedure for the specific removal of lipoprotein (a) (Lp(a)) from human plasma--Lp(a) apheresis--was applied to the treatment of three patients with coronary artery disease documented by angiography. Their initial lipid levels were as follows: total cholesterol, 210-230 mg/dl; low-density lipoprotein (LDL) cholesterol, 140-160 mg/dl; Lp(a), 90-120 mg/dl. The patients underwent a total of 168 procedures without significant side effects. Lp(a) apheresis reduced the Lp(a) level by removing up to 88% of Lp(a). Other plasma compounds, including LDL and plasminogen, remained practically unchanged. Lp(a) apheresis appears to be a unique, effective and specific method for lowering the Lp(a) level. Additional trials are needed to evaluate the clinical effect of this treatment.