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Effect of different LDL‐apheresis methods on parameters involved in atherosclerosis
Author(s) -
Hershcovici Tiberiu,
Schechner Vered,
Orlin Jerome,
Harell Daniella,
Beigel Yitzhak
Publication year - 2004
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.20006
Subject(s) - medicine , apheresis , fibrinogen , ldl apheresis , homocysteine , apolipoprotein b , cholesterol , platelet , ldl cholesterol , endocrinology , gastroenterology
LDL‐apheresis lowers the LDL level in patients with severe hypercholesterolemia. The present study compared three apheresis methods—DSA, DALI, and plasma exchange—for effectiveness in removal of LDL and effect on various blood parameters involved in atherogenesis. The study group included 6 patients with primary hypercholesterolemia unresponsive to maximal drug therapy. All were treated first with 4 consecutive plasma exchange sessions followed by 4 DSA sessions; in four out of six, an additional 4 sessions of DALI were then performed. Levels of lipoproteins, apoproteins, CRP, homocysteine, fibrinogen, and blood count were determined before and after each session. All 3 procedures yielded a significant reduction in total cholesterol and ApoB‐containing lipoproteins, with DALI being the most effective. Also, a significant reduction in triglycerides, HDL, and ApoA 1 was observed with all the methods. The reduction in HDL‐C with DSA and DALI was greater than previously reported. The LDL/HDL‐cholesterol ratio decreased significantly with DSA and DALI and increased with plasma exchange. There was a significant decrease in CRP, fibrinogen, and platelets with all three methods, and a significant decrease in homocysteine only with DSA and DALI. All three procedures effectively reduced the concentration of various compounds involved in atherosclerosis. Plasma exchange is nonselective and cannot be recommended as the procedure of choice. J. Clin. Apheresis 19:90–97, 2004. © 2004 Wiley‐Liss, Inc.