Long-term LDL apheresis does not stably improve hemorheology in hypercholesterolemic patients with coronary artery disease.

Hemorheological abnormalities are independent cardiovascular risk indicators and adversely affect the outcome of cardiovascular disease. Single LDL apheresis treatment was shown to improve blood and plasma viscosity, red cell aggregation and deformability. However, the long-term effects of LDL apheresis on hemorheology are still unknown. Therefore, we investigated hemorheological parameters in 23 patients (11 women, 12 men) with angiographically established coronary heart disease and drug-resistant hypercholesterolemia regularly treated with LDL apheresis for 7.6+/-3.1 years. Hemorheological measurements (whole blood viscosity, plasma viscosity, red blood cell aggregation at stasis and low shear rate) were analyzed in all patients before and after the initial LDL apheresis as well as before a current LDL apheresis. Single LDL apheresis resulted in significantly reduced plasma viscosity, whole blood viscosity and erythrocyte aggregation index. However, long-term apheresis had no sustained effect on plasma and whole blood viscosity. Our data indicate that in contrast to its beneficial short-term effects, long-term LDL apheresis does not stably improve hemorheology.