Lipoprotein apheresis in patients with familial hypercholesterolemia: a single center research.
10.3760/cma.j.cn112148-20210715-00591
- Author:
Liang ZHAO
1
;
Ying GAO
1
;
Geng LIU
1
;
Cui Na JIA
1
;
Jing ZHANG
1
;
Qian DONG
1
;
Xiao Lin LI
1
;
Cheng Gang ZHU
1
;
Na Qiong WU
1
;
Yuan Lin GUO
1
;
Jian Jun LI
1
Author Information
1. Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
- Publication Type:Journal Article
- MeSH:
Adult;
Blood Component Removal/methods*;
Cholesterol, LDL;
Cross-Sectional Studies;
Female;
Humans;
Hyperlipoproteinemia Type II/therapy*;
Lipoprotein(a)/chemistry*;
Lipoproteins/chemistry*;
Male;
Middle Aged;
Retrospective Studies
- From:
Chinese Journal of Cardiology
2022;50(6):585-590
- CountryChina
- Language:Chinese
-
Abstract:
Objective: We evaluated the safety and efficacy of lipoprotein apheresis (LA) in patients with familial hypercholesterolemia (FH) who can't reach low-density lipoprotein cholesterol(LDL-C) target goals with the maximal tolerated dose of lipid-lowering agents. Methods: This was a retrospective cross-sectional study. Between February 2015 and November 2019, patients with FH who were admitted in Fuwai hospital and treated with LA were consecutively enrolled. Based on intensive lipid-lowering agents, these patients received LA by double filtration plasma pheresis (DFPP) method. The changes of lipid levels such as LDL-C and lipoprotein(a)[Lp(a)] were compared before and after LA treatment, and the changes of immunoglobulin (Ig) concentration and LA-related adverse effects were also discussed. Results: A total of 115 patients with FH were enrolled in this study, of which 8 cases were homozygous FH and 107 cases were heterozygous FH. The age was (43.9±12.2) years and there were 75 (65.2%) males, and 108 (93.8%) with coronary artery disease. For pre-and immediately after LA treatment, the LDL-C was (5.20±2.94) mmol/L vs. (1.83±1.08) mmol/L, Lp(a) concentration was 428.70(177.00, 829.50)mg/L vs. 148.90(75.90, 317.00) mg/L (P<0.001), with a decrease of 64.2% and 59.8% respectively. The levels of IgG and IgA measured 1 day after LA treatment were both in the normal range and IgM concentration was below the reference value, the reductions of which were 15.1%, 25.0% and 58.7% respectively (P<0.001). Six patients had mild symptoms of nausea, hypotension dyspnea and palpitation, the symptoms were relieved by symptomatic treatment. Conclusion: For patients with FH who do not achieve LDL-C target goal with the maximal tolerated lipid-lowering agents, especially those with elevated Lp(a) levels, LA, which can significantly further reduce LDL-C and Lp(a) levels, is an effective and safe option.
