LDL-apheresis (LDLa) efficacy in the treatment of symptomatic HyperLp(a)lipoproteinemia -HyperLp(a)- has been studied in a multicentre trial. After 3.1 +/- 2.7 years of weekly and biweekly treatment, the data from 19 patients (males: 12; females: 7; aged 53.8 +/- 9.3 years; mean body mass index: 24.6 +/- 2.3 Kg/m(2)) were evaluated. Data were collected using the same questionnaire shared by 5 participating centres. A total of 2331 procedures were performed. A mean of 3593.7 +/- 800.3 ml of plasma or 8115.3 +/- 2150.1 ml of blood, depending upon the technique used (H.E.L.P., D.A.LI., Dextransulphate, Lipocollect 200), was regularly treated on average every 10.1 +/- 2.6 days. Baseline mean Lp(a) levels were 172.3 +/- 153.8 mg/dL. The mean pre-/post-apheresis Lp(a) levels decreased from 124.5 +/- 107.2 mg/dL (p <= 0.001 vs baseline) to 34.2 +/- 40.6 mg/dL (p <= 0.001 vs pre-). Baseline mean LDL-cholesterol (LDLC) levels were 152.3 +/- 74.6 mg/dL. The mean pre-/postapheresis LDLC levels decreased from 130.4 +/- 61.1 mg/dL (p <= 0.004 vs baseline) to 41.2 +/- 25.1 mg/dL (p <= 0.001 vs pre-). The hypolipidemic drugs given to the patients during LDLa were: ezetimibe+simvastatin, atorvastatin, rosuvastatin, pravastatin, acipimox, and omega-3 fatty acids. 58% of the patients had arterial hypertension. Cigarette smokers were 5.3%. Alcohol intake was present in 21%. 52.6% were physically active. Patients with coronary artery disease (CAD) submitted to coronary catheterization before LDLa were 95%. In 5.5% (#1) CAD recurred despite treatment with LDLa. 79% were submitted to coronary revascularization before LDLa. CAD was: monovasal in 8 patients (42.1%), bivasal in 5 (26.4%), trivasal in 4 (21%), plurivasal in 2 (10.5%). In 94.5% of the sample the lesions were stable (< 0% deviation) over 3.1 +/- 2.7 years. 37% had both CAD and extra-coronary artery disease. This multicentre study confirmed that long-term treatment with LDLa was at least able to stabilize CAD in the majority of the individuals with symptomatic HyperLp(a).
Treatment of symptomatic HyperLp(a)lipoproteinemia with LDL-apheresis: a multicentre study / Stefanutti, Claudia; G., Dalessandri; G., Russi; G., De Silvestro; M. G., Zenti; P., Marson; D., Belotherkovsky; A., Vivenzio; S., Di Giacomo. - In: ATHEROSCLEROSIS SUPPLEMENTS. - ISSN 1567-5688. - STAMPA. - 10:5(2009), pp. 89-94. (Intervento presentato al convegno 1st Dresden International Symposium on Therapeutic Apheresis - Recent Progress in Therapeutic Apheresis tenutosi a Dresden, GERMANY nel DEC, 2009) [10.1016/s1567-5688(09)71819-7].
Treatment of symptomatic HyperLp(a)lipoproteinemia with LDL-apheresis: a multicentre study
STEFANUTTI, Claudia;
2009
Abstract
LDL-apheresis (LDLa) efficacy in the treatment of symptomatic HyperLp(a)lipoproteinemia -HyperLp(a)- has been studied in a multicentre trial. After 3.1 +/- 2.7 years of weekly and biweekly treatment, the data from 19 patients (males: 12; females: 7; aged 53.8 +/- 9.3 years; mean body mass index: 24.6 +/- 2.3 Kg/m(2)) were evaluated. Data were collected using the same questionnaire shared by 5 participating centres. A total of 2331 procedures were performed. A mean of 3593.7 +/- 800.3 ml of plasma or 8115.3 +/- 2150.1 ml of blood, depending upon the technique used (H.E.L.P., D.A.LI., Dextransulphate, Lipocollect 200), was regularly treated on average every 10.1 +/- 2.6 days. Baseline mean Lp(a) levels were 172.3 +/- 153.8 mg/dL. The mean pre-/post-apheresis Lp(a) levels decreased from 124.5 +/- 107.2 mg/dL (p <= 0.001 vs baseline) to 34.2 +/- 40.6 mg/dL (p <= 0.001 vs pre-). Baseline mean LDL-cholesterol (LDLC) levels were 152.3 +/- 74.6 mg/dL. The mean pre-/postapheresis LDLC levels decreased from 130.4 +/- 61.1 mg/dL (p <= 0.004 vs baseline) to 41.2 +/- 25.1 mg/dL (p <= 0.001 vs pre-). The hypolipidemic drugs given to the patients during LDLa were: ezetimibe+simvastatin, atorvastatin, rosuvastatin, pravastatin, acipimox, and omega-3 fatty acids. 58% of the patients had arterial hypertension. Cigarette smokers were 5.3%. Alcohol intake was present in 21%. 52.6% were physically active. Patients with coronary artery disease (CAD) submitted to coronary catheterization before LDLa were 95%. In 5.5% (#1) CAD recurred despite treatment with LDLa. 79% were submitted to coronary revascularization before LDLa. CAD was: monovasal in 8 patients (42.1%), bivasal in 5 (26.4%), trivasal in 4 (21%), plurivasal in 2 (10.5%). In 94.5% of the sample the lesions were stable (< 0% deviation) over 3.1 +/- 2.7 years. 37% had both CAD and extra-coronary artery disease. This multicentre study confirmed that long-term treatment with LDLa was at least able to stabilize CAD in the majority of the individuals with symptomatic HyperLp(a).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
