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Lp(a) apheresis for the treatment of severe CHD patients with Lp(a) hyperlipidemia
Author(s) -
Pokrovsky Sergei,
Straube R.,
Afanasieva O.,
Kukharchuk V.,
Konovalov G.
Publication year - 2005
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2005.00324_9.x
Subject(s) - medicine , lipoprotein(a) , apheresis , hyperlipidemia , lipoprotein , cardiology , coronary artery disease , gastroenterology , ldl apheresis , cholesterol , urology , endocrinology , platelet , diabetes mellitus
Objectives. To demonstrate the effectiveness of the specific lipoprotein(a)[Lp(a)] removal with immunosorption columns for treatment of severe CHD patients with elevated (more than 30 mg/dL) Lp(a) level. Methods. The following inclusion criteria were used for the recruitment of patients: age – under 55; coronary atherosclerosis documented by angiography; Lp(a) greater than 60 mg/dl; normal total and LDL cholesterol; clinically apparent progression of the CHD. Specific removal of Lp(a) from plasma was carried out with immunosorbtion columns ‘Lp(a) Lipopak’ contained specific antibodies against human Lp(a). Results. During last 10 years more than 1200 Lp(a) apheresis procedures have been carried out for ten severe CHD patients with 2–3 vessels disease in Moscow, Russia and Ludenscheid, Germany with Lp(a) Lipopak columns (POCARD Ltd, Russia). The Lp(a) level was reduced on the average on 75–85%, other parameters are practically constant during one procedure and duting all period of treatment. Our experience with Lp(a) Lipopak columns has shown that the specific removal of Lp(a) from the patient's plasma to 30 mg/dL or lower by weekly Lp(a) apheresis resulted in a significant improvement in the patient's health status and quality of life. After numerous Lp(a) apheresis procedures the progression of atherosclerosis was stopped in all cases, while some segments of coronary arteries showed regression of atherosclerotic plaques. Conclusion. We conclude that Lp(a) apheresis could be a very effective therapy for severe CHD patients with elevated Lp(a), and/or Lp(a) and LDL but for whom LDL level could be effectively corrected by lipids lowering drugs.