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Lipid apheresis

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https://www.readbyqxmd.com/read/29114919/circulating-progenitor-cells-in-patients-with-familial-hypercholesterolemia
#1
P B Sandesara, V Ramjee, N Ghasemzadeh, Y Guo, N Bhatia, Q Li, L Vaughn, C Nell-Dybdahl, E K Waller, E A Mahar, K Brigham, P W F Wilson, A Quyyumi, N-A Le, L S Sperling
OBJECTIVE: Familial hypercholesterolemia (FH) is a genetic disease with very high levels of circulating low density lipoprotein cholesterol (LDL-C) levels that leads to accelerated atherosclerosis. Lipoprotein apheresis is an effective treatment option for patients with FH and results in reduced cardiovascular morbidity and mortality. Circulating progenitor cells (CPCs) are markers of overall vascular health and diminished levels have been associated with decreased reparative potential and worse outcomes...
November 8, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29106543/survival-in-homozygous-familial-hypercholesterolaemia-is-determined-by-the-on-treatment-level-of-serum-cholesterol
#2
Gilbert R Thompson, Dirk J Blom, A David Marais, Mary Seed, Gillian J Pilcher, Frederick J Raal
Aims: Homozygous familial hypercholesterolaemia (FH) is a rare inherited disorder characterized by extreme hypercholesterolaemia from birth, accelerated atherosclerosis, and premature death. Many forms of lipid-lowering therapies have been used in the past, but definitive evidence of benefit has been lacking. We therefore undertook a retrospective survey of lipid levels and clinical outcomes of FH homozygotes treated with a combination of lipid-lowering measures between 1990 and 2014 in South Africa and the UK...
July 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29096861/current-insights-into-the-german-lipoprotein-apheresis-registry-glar-almost-5-years-on
#3
V J J Schettler, C L Neumann, C Peter, T Zimmermann, U Julius, E Roeseler, F Heigl, P Grützmacher, H Blume
BACKGROUND: In recent years the Federal Joint Committee (G-BA), a paramount decision-making body of the German health care system required a reassessment of the approval of chronic lipoprotein apheresis therapy for regular reimbursement. Since 2005 an interdisciplinary German apheresis working group has been established by members of both German Societies of Nephrology. In 2009 the working group completed the indication for lipoprotein apheresis with respect to current cardiovascular guidelines and current scientific knowledge for the registry...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096860/current-insights-into-the-german-lipoprotein-apheresis-standard-pcsk9-inhibitors-lipoprotein-apheresis-or-both
#4
V J J Schettler, J Ringel, S Jacob, U Julius, R Klingel, F Heigl, E Roeseler, P Grützmacher
According to current European guidelines, lipid lowering therapy for progressive cardiovascular disease including cardiovascular events has to be focused on a target level for LDL-C. In contrast for Lp(a) a threshold has to be defined with respect to the method of measurement. However, due to new lipid lowering drug developments like PCSK9-inhibitors (PCSK-9-I) a therapeutic algorithm for patients with severe hypercholesterolemia or isolated Lipoprotein(a)-hyperlipoproteinemia with progressive cardiovascular disease may be necessary to manage the use of PCSK9-I, lipoprotein apheresis (LA) or both...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096859/lipoprotein-a-apheresis-in-the-light-of-new-drug-developments
#5
Anja Vogt
Elevated levels of lipoprotein(a) (Lp(a)) contribute to the risk of early and severe cardiovascular disease (CVD). Recently <50 mg/dl was recommended as the desirable level for clinical use and decision making. All established medical therapies to lower cholesterol levels have no impact on lowering Lp(a) except niacin which is all too often poorly tolerated and not obtainable everywhere. Lipoprotein apheresis is an extracorporeal treatment to lower levels of Lp(a) significantly by > 60%. In some countries it is recommended in very high risk patients with early or progressive CVD...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096858/management-of-patients-with-statin-intolerance
#6
Sabine Fischer, Ulrich Julius
In recent years statins have become an established option in lipid-lowering pharmacotherapy despite the fact that statin intolerance is fairly common. When muscle pains and/or an elevation of the creatine kinase appear, the dose must be lowered in patients with slight symptoms or stopped altogether if the symptoms are more severe. When the symptoms are alleviated and creatine kinase is normalized, re-exposition can be considered. If symptoms recur, treatment with another statin should be attempted - in these cases pravastatin or fluvastatin are recommended, although they are less effective in reducing LDL cholesterol...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096841/efficacy-of-lipid-reduction-with-dali-and-monet
#7
Wolfgang Ramlow, Eberhard Röseler, Franz Heigl, Ralf Spitthöver, Jens Ringel, Gerd Schmitz, Rainer Heinzler, Nadim Abdul-Rahman, Frank Leistikow, Frido Himmelsbach, Volker Schettler, Jenny Pham, Justyna Kozik-Jaromin
BACKGROUND: Lipidapheresis techniques are increasingly used to treat drug-resistant hyperlipidemia but few efficacy studies under routine application are available. In this multicenter observational study we investigated direct adsorption of lipoproteins (DALI) and lipoprotein filtration (MONET) for the short and the long-term effects on lipid-lowering effects. METHODS: Data of 122 apheresis patients from 11 centers (DALI: n = 78, MONET: n = 44) were prospectively collected for a period of 2 years...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096840/kinetics-of-lipoprotein-a-in-patients-undergoing-weekly-lipoprotein-apheresis-for-lp-a-hyperlipoproteinemia
#8
S Tselmin, G Müller, U Schatz, U Julius, S R Bornstein, B Hohenstein
INTRODUCTION: Lipoprotein apheresis (LA) represents the only effective therapeutic option for patients with elevated Lipoprotein(a) (Lp(a)) levels. We aimed at analyzing the Lp(a) reduction, rebound rates as well as mean interval values between two weekly apheresis sessions, since this might be important for the prediction of the residual cardiovascular risk and development of individualized approaches for this special therapeutic strategy. MATERIALS AND METHODS: 20 patients under weekly and 2 patients under twice weekly apheresis were included...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096839/lipoprotein-apheresis-downregulates-il-1%C3%AE-il-6-and-tnf-%C3%AE-mrna-expression-in-severe-dyslipidaemia
#9
Claudia Stefanutti, Fabio Mazza, Daniela Pasqualetti, Serafina Di Giacomo, Gerald F Watts, Maria Simona Massari, Joel de Neve, Claudia Morozzi, Moritz Fischer
BACKGROUND AND AIMS: Dyslipidaemias are associated with cardiovascular mortality and morbidity, driven by unstable atherosclerotic plaques with inflammatory infiltrates. Levels of messenger RNA (mRNA) for pro-inflammatory cytokines have been positively correlated with atherosclerotic disease progression. Therapeutic lipoprotein apheresis (LA) reduces plasma lipid levels and reduces inflammation. We evaluated the effects of LA on expression of mRNA coding for key pro-inflammatory cytokines in patients with dyslipidaemia, homo-/hetero-zygous familial hypercholesterolaemia (HoFH, HeFH) or hyperlipoprotein(a)aemia [hyperLp(a)] and associated coronary artery disease (CAD)...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096838/effect-of-different-lipid-apheresis-methods-on-plasma-polyunsaturated-fatty-acids
#10
C Schmöcker, U Kassner, A I Ostermann, S Kiesler, E Steinhagen-Thiessen, N H Schebb, K H Weylandt
Lipoprotein apheresis has been shown to improve the cardiovascular outcome in patients with atherosclerotic disease and therapy-refractory hypercholesterolemia or elevated lipoprotein (a) (Lp(a)). An elevated intake of omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has also been associated with a reduced cardiovascular risk. However, until now only little is known about the effect of apheresis treatment on the levels of omega-6 and omega-3 polyunsaturated fatty acids (n-6 PUFA and n-3 PUFA) in patients...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096835/rationale-and-design-of-multiselect-a-european-multicenter-study-on-the-effect-of-lipoprotein-a-elimination-by-lipoprotein-apheresis-on-cardiovascular-outcomes
#11
Bernd Hohenstein, Ulrich Julius, Peter Lansberg, Beate Jaeger, Klaus-Peter Mellwig, Norbert Weiss, Xina Graehlert, Ingo Roeder, Wolfgang Ramlow
BACKGROUND: Dyslipidemia is a well-known risk factor for atherosclerosis and subsequent cardiovascular disease (CVD). While low density lipoprotein cholesterol (LDL-C) is well-established and taken into consideration for risk management and therapy, lipoprotein(a) is another established CVD risk factor frequently not undergoing screening due to a lack of medical treatment options. For patients suffering from CVD due to massive elevation of Lp(a) in presence of normal LDL-C levels, lipoprotein apheresis is the only available treatment option...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096833/specific-lp-a-apheresis-a-tool-to-prove-lipoprotein-a-atherogenicity
#12
S N Pokrovsky, O I Afanasieva, M S Safarova, T V Balakhonova, Yu G Matchin, I Y U Adamova, G A Konovalov, M V Ezhov
BACKGROUND: An elevated lipoprotein(a) (Lp(a)) level is observed in more than 30% of patients with stable ischemic heart disease (SIHD). We conducted an investigation of the effects of specific Lp(a) apheresis on the progression of atherosclerosis in SIHD patients with Lp(a) levels greater than 50 mg/dL. METHODS: We prospectively enrolled 15 patients diagnosed with SIHD based on symptom-driven coronary angiography findings, with Lp(a) ≥50 mg/dL and a low density lipoprotein cholesterol (LDL-C) ≤2...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096832/antioxidant-defense-system-in-familial-hypercholesterolemia-and-the-effects-of-lipoprotein-apheresis
#13
V Blaha, M Blaha, D Solichová, L Kujovská Krčmová, M Lánská, E Havel, P Vyroubal, Z Zadák, P Žák, L Sobotka
Oxidative stress is thought to play an important role in the pathogenesis of disorders associated with atherosclerosis. Alpha-tocopherol is considered to be an effective lipophilic antioxidant, which protects lipid membranes against peroxidation and thus prevents cell damage by reaction with free radicals. However, measurement of alpha-tocopherol concentration in serum does not reflect the content of α-tocopherol in membranes whereas erythrocyte alpha-tocopherol may be good indicator of antioxidative status...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096829/ldl-apheresis-improves-coronary-flow-reserve-on-the-left-anterior-descending-artery-in-patients-with-familial-hypercholesterolemia-and-chronic-ischemic-heart-disease
#14
Tiziana Sampietro, Francesco Sbrana, Emilio Maria Pasanisi, Federico Bigazzi, Christina Petersen, Michele Coceani, Beatrice Dal Pino, Andrea Ripoli, Mascia Pianelli, Roberta Luciani
BACKGROUND: LDL apheresis (LA) influences the microcirculation, endothelial function and cardiovascular homeostasis. The aim of our study was to analyze temporal variations of coronary flow reserve (CFR) on the left anterior descending artery, obtained during dipyridamole stress echocardiography (DSE), in patients with severe familial hypercholesterolemia on LA (LA group) or not (not LA group) and ischemic heart disease (IHD). METHODS: The LA group consisted in 10 patients (mean age 65 ± 7 years, male 70%) with Familial Hypercholesterolemia and chronic IHD on maximally tolerated lipid lowering therapy and chronic LA treatment (median 7 years, interquartile range 6-14 years)...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096828/analysis-of-circulating-mirnas-in-patients-with-familial-hypercholesterolaemia-treated-by-ldl-lp-a-apheresis
#15
Dana Dlouha, Milan Blaha, Vladimir Blaha, Ilona Fatorova, Jaroslav A Hubacek, Petr Stavek, Vera Lanska, Alena Parikova, Jan Pitha
BACKGROUND: LDL/Lp(a) apheresis therapy is a well-established method of aggressively lowering LDL and Lp(a). Recently, miRNAs have been discussed as markers of vascular status including atherosclerosis. MiRNAs inhibit post-transcriptional processes through RNA duplex formation resulting in gene silencing or regulation of gene expression. MATERIALS AND METHODS: We measured a profile of 175 plasma-circulating miRNAs using pre-defined Serum/Plasma Focus Human microRNA PCR Panels in pooled samples of 11 subjects with familial hypercholesterolaemia under long-term apheresis treatment...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096827/pleiotropic-effects-of-regular-lipoprotein-apheresis
#16
Helmut Sinzinger, Sabine Steiner, Kurt Derfler
BACKGROUND: Lipoprotein(LP)-apheresis is the treatment of choice in patients suffering from severe familial hypercholesterolemia. A wide range of mechanisms has been claimed to be responsible for the known clinical benefit. METHODS: Patients suffering from heterozygous familial hypercholesterolemia undergoing LP-apheresis either with direct adsorption of lipoproteins (DALI) or dextran sulfate (DS) were examined. A total volume of 10 l blood was exchanged. Non-lipid effects, mainly concerning endothelial function (circulating endothelial cells, circulating endothelial progenitor cells, flow-mediated vasodilation, microalbuminuria) as well as left ventricular ejection fraction and homocysteine were assessed...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096826/long-term-follow-up-of-circulating-oxidative-stress-markers-in-patients-undergoing-lipoprotein-apheresis-by-direct-adsorption-of-lipids-dali
#17
Steffi Kopprasch, Stefan R Bornstein, Sybille Bergmann, Juergen Graessler, Bernd Hohenstein, Ulrich Julius
OBJECTIVE: Beyond its well-established efficacy in lowering atherogenic lipids and lipoproteins, DALI (Direct Adsorption of Lipids) apheresis has been shown to have acute anti-inflammatory and endothelium-protective effects. In the present study, we investigated long-term effects of DALI procedures on circulating oxidative stress markers. METHODS: Thirteen patients involved in the study underwent regular DALI apheresis for nearly two years. At sessions 1, 40 and 80 conventional lipid status and changes of systemic oxidative stress markers (oxidized LDL, anti-oxidized LDL antibodies, advanced oxidation protein products (AOPP), and myeloperoxidase (MPO)) were examined...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096824/history-of-lipidology-and-lipoprotein-apheresis
#18
Ulrich Julius
This review tells the story of atherosclerosis research in the beginning of the 20th century. It presents the significance of cardiovascular diseases and addresses major questions currently being discussed among lipidologists and the current thinking with respect to low LDL-cholesterol levels and HDL. It provides an overview of the period during which lipid-modifying drugs were introduced and their relevance with respect to cardiovascular outcome data and lists possible reasons why some patients develop new cardiovascular events while being treated with statins...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29072176/premature-coronary-artery-disease-due-to-homozygous-familial-hypercholesterolemia-in-a-12-year-old-girl
#19
Filiz Ekici, Salih Özçobanoğlu, Fırat Kardelen
BACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare inherited metabolic disease, caused by low-density lipoprotein receptor abnormality. Patients with HoFH have an increased risk for cardiovascular complication (CVC) that usually occurs in the first decade of life. We report a twelve years-old girl with unpredicted presentation for coronary artery disease (CAD) and she was found to have HoFH. CASE REPORT: A 12 years old girl was admitted to our unit with syncope...
October 26, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28978219/epidemiology-and-management-of-hyperlipidemia
#20
Samantha Karr
Cardiovascular disease (CVD) is the leading cause of death among adults in the United States, and people with hyperlipidemia are at roughly twice the risk of developing CVD as compared to those with normal total cholesterol levels.1 Patients with familial hypercholesterolemia (FH) have an even greater risk of developing CVD at an earlier age; therefore, early detection and treatment are imperative to reduce cardiovascular events and premature death. Statins are the mainstay treatment for hyperlipidemia; however, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute to poor outcomes...
June 2017: American Journal of Managed Care
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