Indication of low-density lipoprotein apheresis in severe hypercholesterolemia and its atherosclerotic vascular complications: dextran sulfate cellulose low-density lipoprotein apheresis.

Christiane Keller

Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 2004;7(3):345-9

PMID: 12924611

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Abstract

Homozygous familial hypercholesterolemia (FH) and heterozygous FH, with or without elevation of Lp(a), or isolated massive elevation of Lp(a) with clinically relevant coronary heart disease are indications for low-density lipoprotein (LDL) apheresis, as long as maximal conventional lipid lowering drug therapy does not lead to a LDL cholesterol level below 100 mg/dL. Reduction of lipoproteins and Lp(a), of oxidation of LDL, improvement of disturbed vasomotion, the procoagulatory state and disturbed hemorheology associated with atherosclerosis, as well as the stabilization of plaques and the decrease of cytokines and adhesion molecules have been induced by apheresis and are thought to favorably influence regression of artherosclerosis. Several intervention studies point in this direction.

Address: Klinikum Ludwig-Maximilians-Universität, Munich, Germany. [email protected]

DOI: 10.1046/j.1526-0968.2003.00063.x

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MeSH Terms: Blood Component Removal, Cellulose, Cholesterol, LDL, Coronary Artery Disease, Dextran Sulfate, Female, Follow-Up Studies, Humans, Hypercholesterolemia, Lipoproteins, LDL, Male, Plasmapheresis, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Survival Analysis, Treatment Outcome