Lipoprotein apheresis for lipoprotein(a) and cardiovascular disease
| Autor: | Lauryn K. Gorby, Jessica V. Gray, Patrick M. Moriarty |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Population Familial hypercholesterolemia 030204 cardiovascular system & hematology Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Internal Medicine medicine Humans Clinical significance 030212 general & internal medicine Risk factor Child education Retrospective Studies education.field_of_study Nutrition and Dietetics biology business.industry Retrospective cohort study Cholesterol LDL Lipoprotein(a) Middle Aged medicine.disease Treatment Outcome Apheresis Cardiovascular Diseases Blood Component Removal biology.protein Female Cardiology and Cardiovascular Medicine business Lipoprotein |
| Zdroj: | Journal of Clinical Lipidology. 13:894-900 |
| ISSN: | 1933-2874 |
| DOI: | 10.1016/j.jacl.2019.09.010 |
| Popis: | Background Elevated lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular disease (CVD). In the United States, lipoprotein apheresis (LA) therapy is approved for patients with familial hypercholesterolemia. Germany uses LA therapy for patients with an Lp(a) > 60 mg/dL, normal low-density lipoprotein cholesterol (LDL-C) levels, and CVD. LA therapy in this population demonstrated a >70% reduction in CVD events. In the United States, LA is only approved for patients with elevated LDL-C levels, regardless of Lp(a) level. Objective The objective of the study was to evaluate clinical significance of Lp(a) reduction with LA therapy in the United States. Methods A retrospective cohort study at one LA site in the United States evaluated 14 CVD patients with elevated Lp(a) and near normal LDL-C levels. Patient data was analyzed to demonstrate possible clinical benefit in reducing Lp(a) levels with LA to mitigate risk of major adverse cardiovascular events. Results Pre-LA patients’ mean LDL-C and Lp(a) were 80 mg/dL and 138 mg/dL, respectively. LA therapy demonstrated a reduction of mean LDL-C to 29 mg/dL and Lp(a) to 51 mg/dL. These represent a percent reduction of 64% and 63% for LDL-C and Lp(a), respectively. There was a 94% reduction in major adverse cardiovascular events over a mean treatment period of 48 months. Conclusion The treatment of CVD patients with an elevated Lp(a) and near normal LDL-C with LA in a U.S. treatment center demonstrated a significant reduction in future CVD events. LA should be considered for patients in the United States suffering from an elevated Lp(a) and progressive CVD. |
| Databáze: | OpenAIRE |
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