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LDL-apheresis in two patients with extremely elevated lipoprotein (a) levels
R Bambauer1, R Schiel, H E Keller
1University of Saarland, Homburg/Saar, Germany.
The International Journal of Artificial Organs
|May 1, 1995
Summary
LDL-apheresis effectively reduced extremely high lipoprotein (a) [Lp(a)] levels in patients with familial hypercholesterolemia. This treatment also decreased cardiovascular events and improved patient performance.
Area of Science:
- Cardiology
- Biochemistry
- Internal Medicine
Background:
- Elevated lipoprotein (a) [Lp(a)] and hyperlipidemia are associated with premature atherosclerosis.
- Familial hypercholesterolemia presents challenges in lipid management.
- Extreme Lp(a) levels can be resistant to conventional therapies.
Purpose of the Study:
- To evaluate the efficacy of LDL-apheresis in managing extremely high Lp(a) concentrations.
- To assess the impact of LDL-apheresis on lipid profiles and cardiovascular events.
Main Methods:
- Two male patients with heterozygous familial hypercholesterolemia and extreme Lp(a) levels were treated with LDL-apheresis.
- Treatment involved a liposorber system and an immunoadsorption system over 15-55 months.
- Lipid levels, Lp(a), and fibrinogen were monitored.
Main Results:
- LDL-apheresis reduced Lp(a) by 50%, total cholesterol by 27%, LDL-cholesterol by 42%, and triglycerides by 43%.
- Fibrinogen levels decreased by 16%.
- Patients experienced no further myocardial infarctions or cardiac complaints post-treatment, reporting improved performance.
Conclusions:
- LDL-apheresis demonstrates significant effectiveness in reducing extremely high Lp(a) levels.
- The treatment appears to prevent cardiovascular events in patients with resistant hyperlipidemia and high Lp(a).
- LDL-apheresis offers a promising therapeutic option for selected patients with severe lipid disorders.