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Current status of low density lipoprotein-apheresis for the therapy of severe hyperlipidemia
1Rogosin Institute, New York Hospital-Cornell Medical Center, New York 10021, USA.
Insights
LDL-apheresis is increasingly used for severe hypercholesterolemia, especially in coronary artery disease patients. Newer technologies offer improved treatment options beyond plaque regression.
Area of Science:
- Cardiology
- Biochemistry
- Medical Technology
Background:
- Severe hypercholesterolemia poses significant risks, particularly for patients with coronary artery disease.
- LDL-apheresis has emerged as a valuable therapeutic option for managing this condition.
- Clinical acceptance of LDL-apheresis has notably increased in recent years.
Purpose of the Study:
- To review the current clinical acceptance and technological advancements in LDL-apheresis.
- To explore the various systems and emerging technologies used for LDL-apheresis.
- To discuss the broader mechanisms of clinical improvement associated with LDL-apheresis.
Main Methods:
- Review of current clinical practices and technologies in LDL-apheresis.
- Description of commonly employed systems: immunoadsorption, dextran sulfate cellulose, and heparin precipitation.
- Highlighting novel technologies: whole-blood compatible columns, double-filtration plasmapheresis, and lipoprotein (a)-apheresis.
Main Results:
- Wider clinical acceptance of LDL-apheresis for severe hypercholesterolemia, especially in coronary artery disease.
- Established methods include immunoadsorption, dextran sulfate cellulose, and heparin precipitation.
- Emerging technologies offer improved efficacy and broader applications.
Conclusions:
- LDL-apheresis is a clinically accepted and evolving treatment for severe hypercholesterolemia.
- Technological advancements are expanding the utility and effectiveness of apheresis therapies.
- Clinical benefits of LDL-apheresis involve mechanisms beyond simple atherosclerotic plaque regression.
Abstract:
The use of LDL-apheresis to treat patients with severe hypercholesterolemia has gained wider clinical acceptance during the past 2-3 years, particularly in patients with coronary artery disease. Systems utilizing immunoadsorption columns, dextran sulfate cellulose columns and heparin precipitation have been most commonly employed. New or improved technologies include whole-blood compatible columns, double-filtration plasmapheresis and lipoprotein (a)-apheresis. The mechanisms for clinical improvement extend beyond simple regression of atherosclerotic plaque.