Long-term effects of LDL apheresis in patients with severe hypercholesterolemia

被引:43
作者
Sachais, BS
Katz, J
Ross, J
Rader, DJ
机构
[1] Univ Penn, Sch Med, Div Transfus Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA
关键词
hypercholesterolemia; atherosclerosis; cardiovascular; myocardial infarction;
D O I
10.1002/jca.20036
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Familial hypercholesterolemia (FH) is an inherited disorder of lipoprotein metabolism involving mutations in the LDL receptor (LDL-R). Patients with mutation in one (heterozygous) or both (homozygous) genes have markedly elevated LDL cholesterol and are at increased risk for coronary heart disease (CHD). Aggressive lipid lowering is required for homozygous and many heterozygous FH patients. This often involves LDL-apheresis, where LDL and other apo-B containing lipoproteins are selectively removed from the plasma. We have retrospectively studied 34 patients treated with biweekly LDL-apheresis at the Hospital of the University of Pennsylvania. In our patient Population, adverse events were uncommon and rarely resulted in shortened treatment time. There was a dramatic decrease in the relative risk of cardiovascular events and cardiovascular interventions in patients treated with LDL-apheresis for an average of 2.5 years. Some but not all patients had long-term reduction in their LDL levels as a result of LDL-apheresis, suggesting that time-averaged reduction in LDL and/or LDL:HDL ratios were responsible for clinical improvement. These data Support the use of LDL-apheresis in patients with FH, as well as medication-intolerant patients that have elevated LDL cholesterol despite maximal pharmacological treatment.
引用
收藏
页码:252 / 255
页数:4
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