Lipoprotein apheresis – Shortening of treatment intervals reduces cardiovascular events: Case reports
| Autor: | Robert Berent, Helmut Sinzinger, Theresa Berent |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Hyperlipoproteinemias medicine.medical_specialty Time Factors 030204 cardiovascular system & hematology Angina 03 medical and health sciences 0302 clinical medicine Clinical Protocols Internal medicine Internal Medicine Humans Medicine In patient 030212 general & internal medicine Coronary atherosclerosis Aged biology business.industry General Medicine Lipoprotein(a) medicine.disease Apheresis Cardiovascular Diseases Blood Component Removal biology.protein Cardiology Female Lipid lowering Cardiology and Cardiovascular Medicine business Lipoprotein apheresis Lipoprotein |
| Zdroj: | Atherosclerosis Supplements. 40:125-130 |
| ISSN: | 1567-5688 |
| DOI: | 10.1016/j.atherosclerosissup.2019.08.024 |
| Popis: | Background Lipoprotein (Lp-) apheresis is a life-long therapy, usually performed in weekly intervals. In some cases, however, atherosclerotic disease progresses despite adequate therapy with weekly Lp-apheresis and maximal lipid lowering medication. In an attempt to improve the effectiveness of therapy, we temporarily shortened treatment intervals of Lp-apheresis in patients with elevated lipoprotein(a) (Lp(a)) and further progression of coronary atherosclerosis despite weekly Lp-apheresis and maximal lipid lowering medication. Methods We illustrate three case reports of patients with elevated Lp(a), who underwent regular weekly Lp-apheresis treatment for secondary prevention. The intensified treatment protocol contained three therapies in two weeks (alternating 2 per week and 1 per week). Results The shortening of treatment intervals achieved a stabilization of atherosclerotic disease in case 1. After a total of 68 therapies in 52 weeks (1.31 sessions/week) the elective coronary angiography revealed excellent long-term results. In case 2, the intensified treatment protocol is still ongoing. The patient reported a decrease in angina pectoris and an increase in exercise capacity since the beginning of more frequent therapy sessions. In some cases, as it is shown in case 3, a fast decision for shortening the treatment intervals is necessary. Conclusions The intensified treatment regimen resulted in an improvement in clinical symptoms and no further progression of atherosclerosis. In conclusion, shorter therapeutic Lp-apheresis intervals, at least temporarily, should be considered in patients who suffer from clinical and/or angiographic progression of atherosclerosis, despite maximal lipid lowering medication and weekly Lp-apheresis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect