Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989-2017
| Autor: | Alison Pottle, S. Walji, Suzanne Watkins, Gilbert R. Thompson, Jaimini Cegla, Clare Neuwirth, Graham Bayly, Hazel Weedon, Handrean Soran, Vaishali Kale, Tina Dawson, Mahmoud Barbir, Ruth Eatough, Jules Payne, James Scott, Kirsty Nicholson, D. Datta, Robert Cramb |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Heterozygote Time Factors Adolescent 030204 cardiovascular system & hematology Hyperlipoproteinemia Type II 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Internal medicine medicine Humans Genetic Predisposition to Disease Registries Child Aged Retrospective Studies Descriptive statistics biology business.industry Incidence Homozygote Infant Lipoprotein(a) Cholesterol LDL Middle Aged United Kingdom 030104 developmental biology Treatment Outcome Cardiovascular Diseases Child Preschool biology.protein Blood Component Removal Registry data Observational study Female Cardiology and Cardiovascular Medicine business Lipoprotein apheresis Mace Biomarkers |
| Zdroj: | Atherosclerosis. 290 |
| ISSN: | 1879-1484 |
| Popis: | Background and aims In 2008, the National Institute of Health and Care Excellence in the UK recommended that patients undergoing lipoprotein apheresis (LA) should be included in an anonymised registry. The UK Lipoprotein Apheresis Registry was subsequently established in 2011. Methods Between 2011 and 2017, data was entered retrospectively and prospectively by seven LA centres in the UK for 151 patients. Twenty-two patients were involved in a research study and were therefore excluded from the analysis. Observational data was analysed for the remaining 129 patients. Results Most patients had heterozygous familial hypercholesterolaemia (HeFH) (45.0%); 23.3% had homozygous FH (HoFH); 7.8% had hyper-lipoproteinaemia (a) (Lp(a)) and 24.0% had other forms of dyslipidaemia. Detailed treatment data is available for 63 patients relating to 348 years of LA treatment. The number of years of treatment per patient ranged from 1 to 15. The mean reduction in interval mean LDL-C from the pre-procedure baseline was 43.14%. The mean reduction in interval mean Lp(a) from baseline was 37.95%. The registry data also shows a 62.5% reduction in major adverse cardiovascular events (MACE) between the 2 years prior to, and the first 2 years following introduction of LA. Conclusions The data generated by the UK Lipoprotein Apheresis Registry demonstrates that LA is a very efficient method of reducing LDL-C and Lp(a) and lowers the incidence rate of MACE. LA is an important tool in the management of selected patients with HoFH and drug-resistant dyslipidaemias. |
| Databáze: | OpenAIRE |
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