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News & Press: Clinical News

Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy

Tuesday, December 17, 2013   (2 Comments)
Posted by: Sandra Tremulis
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Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy

 

Background—Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment.

Methods and Results—In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56±1.04 mmol·L−1 (99.0±40.1 mg·dL−1) and Lp(a) 3.74±1.63 µmol·L−1 (104.9±45.7 mg·dL−1), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (P<0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (P<0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (P=0.001) for y-2 to y-1 before LA, decline to 0.14 from y-1 to y+1 (P<0.0001) and to 0.05 from y+1 to y+2 (P=0.014).

Conclusions—In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.

Comments...

George Soul Jr says...
Posted Monday, February 3, 2014
This is good news for those that are aware that they have this condition. I had to tell my doctor that I wanted to be treated aggressively. It's tricky to get the treatment and testing because of insurance restrictions. Sadly, some testing and or medication might have to be paid for out of pocket. On my last doctor visit I was told my insurance would no longer cover specific Lp(a) testing. Fortunately since I know it was high from a previous test at least we could discuss it. So for now our current goal to bring down LDL as low as possible then I'll pay for a Lp(a) test to see were I'm at.
monica choudhury says...
Posted Thursday, January 23, 2014
it is all very promising

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