We present results of the second survey of the Italian Multicenter Study on Low-Density Lipoprotein Apheresis (IMSLDLa-WG/2). The study involved 18 centers in 2009, treating 66 males and 35 females, mean age 47 +/- 18 years. Mean age for initiation of drug treatment before low-density lipoprotein apheresis (LDLa) was 31 +/- 18 years, mean age to the first LDLa was 37 +/- 20 years and average duration of treatment was 9 +/- 6 years. The techniques used included direct adsorption of lipids, dextran sulfate cellulose adsorption, heparin-mediated low-density lipoprotein (LDL) precipitation, cascade filtration, and plasma exchange. The mean treated plasma/blood volumes/session were 3127 +/- 518mL and 8666 +/- 1384mL, respectively. The average plasma volume substituted was 3500 +/- 300mL. Lipid therapy before LDLa included ezetimibe, statins, -3 fatty acids and fenofibrate. Baseline mean LDL cholesterol (LDLC) levels were 386 +/- 223mg/dL. The mean before/after apheresis LDLC level decreased by 67% from 250 +/- 108mg/dL (P=0.05 vs. baseline) to 83 +/- 37mg/dL (P=0.001 vs. before). Baseline mean Lipoprotein(a) [Lp(a)] level was 179 +/- 136mg/dL. Mean before/after apheresis Lp(a) level decreased by 71% from 133 +/- 120mg/dL (P=0.05 vs. baseline) to 39 +/- 44mg/dL (P=0.001 vs. before). Major and minor side effects occurred in 27 and 62 patients, respectively. Among patients with coronary artery disease (CAD), 62.3% had coronary angiography and 50.4% coronary revascularization before LDLa. Single vessel, double vessel and triple vessel CAD occurred in 19 (30.1%), 15 (23.8%) and 29 (46%) patients, respectively. Both CAD and extra-CAD occurred in 41.5%, 39% had hypertension, 9.9% were smokers, 9.9% consumed alcohol and 42% were physically active. Ischemic cardiovascular events were not observed in any patient over 9 +/- 6 years of treatment. Two centers have also treated 34 patients (females: 17/males 17; no. sessions: 36; average plasma volume treated: 3000mL) for sudden hearing loss (SHL). Relief of symptoms was obtained, independently of the system used (HELP; cascade-filtration).

Italian Multicenter Study on Low-Density Lipoprotein Apheresis Working Group 2009 Survey / Stefanutti, Claudia; Morozzi, Claudia; DI GIACOMO, Serafina; The Italian Multicenter Study O. N., Low Density Lipoprotein Apheresis Working Group. - In: THERAPEUTIC APHERESIS AND DIALYSIS. - ISSN 1744-9987. - STAMPA. - 17:2(2013), pp. 169-178. [10.1111/j.1744-9987.2012.01142.x]

Italian Multicenter Study on Low-Density Lipoprotein Apheresis Working Group 2009 Survey

STEFANUTTI, Claudia;MOROZZI, CLAUDIA;DI GIACOMO, SERAFINA;
2013

Abstract

We present results of the second survey of the Italian Multicenter Study on Low-Density Lipoprotein Apheresis (IMSLDLa-WG/2). The study involved 18 centers in 2009, treating 66 males and 35 females, mean age 47 +/- 18 years. Mean age for initiation of drug treatment before low-density lipoprotein apheresis (LDLa) was 31 +/- 18 years, mean age to the first LDLa was 37 +/- 20 years and average duration of treatment was 9 +/- 6 years. The techniques used included direct adsorption of lipids, dextran sulfate cellulose adsorption, heparin-mediated low-density lipoprotein (LDL) precipitation, cascade filtration, and plasma exchange. The mean treated plasma/blood volumes/session were 3127 +/- 518mL and 8666 +/- 1384mL, respectively. The average plasma volume substituted was 3500 +/- 300mL. Lipid therapy before LDLa included ezetimibe, statins, -3 fatty acids and fenofibrate. Baseline mean LDL cholesterol (LDLC) levels were 386 +/- 223mg/dL. The mean before/after apheresis LDLC level decreased by 67% from 250 +/- 108mg/dL (P=0.05 vs. baseline) to 83 +/- 37mg/dL (P=0.001 vs. before). Baseline mean Lipoprotein(a) [Lp(a)] level was 179 +/- 136mg/dL. Mean before/after apheresis Lp(a) level decreased by 71% from 133 +/- 120mg/dL (P=0.05 vs. baseline) to 39 +/- 44mg/dL (P=0.001 vs. before). Major and minor side effects occurred in 27 and 62 patients, respectively. Among patients with coronary artery disease (CAD), 62.3% had coronary angiography and 50.4% coronary revascularization before LDLa. Single vessel, double vessel and triple vessel CAD occurred in 19 (30.1%), 15 (23.8%) and 29 (46%) patients, respectively. Both CAD and extra-CAD occurred in 41.5%, 39% had hypertension, 9.9% were smokers, 9.9% consumed alcohol and 42% were physically active. Ischemic cardiovascular events were not observed in any patient over 9 +/- 6 years of treatment. Two centers have also treated 34 patients (females: 17/males 17; no. sessions: 36; average plasma volume treated: 3000mL) for sudden hearing loss (SHL). Relief of symptoms was obtained, independently of the system used (HELP; cascade-filtration).
2013
italian multicenter study on low-density-lipoprotein-apheresis (imsldla-wg/2); coronary artery disease; low-density-lipoprotein-apheresis; genetic dyslipidemia; multicenter study; therapeutic plasmapheresis; low-density lipoprotein apheresis
01 Pubblicazione su rivista::01a Articolo in rivista
Italian Multicenter Study on Low-Density Lipoprotein Apheresis Working Group 2009 Survey / Stefanutti, Claudia; Morozzi, Claudia; DI GIACOMO, Serafina; The Italian Multicenter Study O. N., Low Density Lipoprotein Apheresis Working Group. - In: THERAPEUTIC APHERESIS AND DIALYSIS. - ISSN 1744-9987. - STAMPA. - 17:2(2013), pp. 169-178. [10.1111/j.1744-9987.2012.01142.x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/461639
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