Safety and effectiveness of long-term LDL-apheresis in patients at high risk

Current Opinion in Lipidology

Volumn 9, Issue 6, 1998, Pages 521-526

  Thiery, Joachim ^a   Seidel, Dietrich ^a  

^a LUDWIG MAXIMILIANS UNIVERSITY   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ANTILIPEMIC AGENT; FIBRINOGEN; HEPARIN; LIPOPROTEIN A; LOW DENSITY LIPOPROTEIN; STATIN;

BLOOD FLOW; CARDIOVASCULAR DISEASE; CORONARY ARTERY DISEASE; EXTRACORPOREAL CIRCULATION; FIBRINOGEN BLOOD LEVEL; HEART TRANSPLANTATION; HUMAN; HYPERCHOLESTEROLEMIA; LIPID BLOOD LEVEL; LIPID OXIDATION; PLASMAPHERESIS; PRIORITY JOURNAL; REVIEW; RISK; SURVIVAL TIME; VASCULAR ENDOTHELIUM;

CHOLESTEROL, LDL; HEART TRANSPLANTATION; HUMANS; HYPERCHOLESTEROLEMIA; MUSCLE, SMOOTH, VASCULAR; OXIDATION-REDUCTION; PLASMAPHERESIS;

EID: 0032439751     PISSN: 09579672     EISSN: None     Source Type: Journal    
DOI: 10.1097/00041433-199812000-00002     Document Type: Review

References (45)

1. Braunwald E. Shattuck lecture-cardiovascular medicine at the turn of the millenium: triumphs, concerns, and opportunities. N Engl J Med 1997; 337:1360-1369. This review provides an overview concerning the prevention of coronary artery disease and the decrease in coronary mortality by effective modification of risk factors, particularly by drastic reduction of plasma LDL cholesterol levels.
2. Gordon BR, Saal SD. Current status of low density lipoprotein-apheresis for the therapy of severe hyperlipidemia. Curr Opin Lipidol 1996; 7:381-384.
3. Lupien PJ, Moorjani S, Awad J. A new approach to the management of familial hypercholesterolemia: removal of plasma-cholesterol based on the principle of affinity chromatography. Lancet 1976; 1:1261-1265.
4. Stoffel W, Borberg H, Greve V. Application of specific extracorporeal removal of low density lipoproteins in familial hypercholesterolemia. Lancet 1981; 2:1005-1007.
5. Yokoyama S, Hayashi R, Satani M, Yamamoto A. Selective removal of low density lipoprotein by plasmapheresis in familial hypercholesterolemia. Arteriosclerosis 1985; 5:613-622.
6. Eisenhauer Th, Armstrong VW, Wieland H, Fuchs C, Nebendahl K, Scheler F, Seidel D. Selective continuous elimination of low density lipoproteins (LDL) by heparin precipitation: first clinical application. ASAIO-Trans 1986; 32:104-107.
7. Schaumann D, Welch-Wichary M, Voss A, Schmidt H, Olbricht CJ. Prospective cross-over comparisons of three low-density lipoprotein (LDL)-apheresis methods in patients with familial hypercholesterolemia. Eur J Clin Invest 1996; 26:1033-1038.
8. Gordon BR, Kelsey SF, Dau PC, Gotto AM Jr, Graham K, Illingworth DR, et al. Long-term effects of low-density lipoprotein apheresis using an automated dextran sulfate cellulose adsorption system. Liposorber Study Group. Am J Cardiol 1998; 81:407-411. This study reports on the long-term safety, lipid lowering and clinical efficacy of LDL-apheresis using a dextran sulfate cellulose adsorption column technique for a 5-year period in patients with heterozygous and homozygous familial hypercholesterolemia who were inadequately controlled by drug therapy. The impressive decrease of cardiovascular events during the period of apheresis treatment compared with the high number of events during the 5 years before initiation of LDL-apheresis clearly demonstrates the clinical benefit of long-term apheresis in patients at high risk.
9. Kojima S, Harada-Shiba M, Nomura S, Kimura G, Tsushima M, Kuramochi M, et al. Effect of nafamostat mesilate on bradykinin generation during low-density lipoprotein apheresis using a dextran sulfate cellulose column. ASAIO-Trans 1991; 37:644-648.
10. Kojima S, Ogi M, Yoshitomi Y, Kuramochi M, Ikeda J, Naganawa M, Hatakeyama H. Changes in bradykinin and prostaglandins plasma levels during dextran-sulfate low-density apheresis. Int J Artif Organs 1997; 20:178-183. This study supports the view that in patients taking angiotensin-converting enzyme inhibitors, the anaphylactoid reaction occurring during apheresis using dextran sulfate cellulose adsorption column technique may be caused by an excessive rise in bradykinin levels via activation of the prostaglandin system, particularly of prostaglandin E2.
11. Olbricht CJ, Schaumann D, Fischer D. Anaphylactoid reactions, LDL-apheresis with dextran sulphate, and ACE inhibitors. Lancet 1992; 340:908-909.
12. Thiery J, Walli AK, Janning G, Seidel D. Low-density lipoprotein plasmapheresis with and without lovastatin in the treatment of the homozygous form of familial hypercholesterolemia. Eur J Pediatr 1990; 149:716-721.
13. Marais AD, Naumova RP, Firth JC, Penny C, Neuwirth CK, Thompson GR. Decreased production of low density lipoprotein by atorvastatin after apheresis in homozygous familial hypercholesterolemia. J Lipid Res 1997; 38:2071-2078. A new study on the mechanism of action of atorvastatin in patients with homozygous familial hypercholesterolemia undergoing LDL-apheresis suggesting that atorvastatin decreases the rate of produciton of LDL.
14. Schuff-Werner P, Gohlke H, Bartmann U, Baggio G, Corti MC, Dinsenbacher A, et al. The HELP-LDL-apheresis multicentre study, an angiographically assessed trial on the role of LDL-apheresis in the secondary prevention of coronary heart disease. II. Final evaluation of the effect of regular treatment on LDL-cholesterol plasma concentrations and the course of coronary heart disease. The HELP-Study Group. Eur J Clin Invest 1994; 24:724-732.
15. Kroon AA, Aengevaeren WR, van der Werf T, Uijen GJ, Reiber JH, Bruschke AV, Stalenhoef AF. LDL-Apheresis Atherosclerosis Regression Study (LAARS). Effect of aggressive versus conventional lipid lowering treatment on coronary atherosclerosis. Circulation 1996; 93:1826-1827.
16. Donner MG, Richter WO, Schwandt P. Long term effect of LDL-apheresis on coronary heart disease. Eur J Med Res 1997; 2:270-274. A study comparing the long-term safety and efficacy of three LDL-apheresis procedures.
17. Bosch T, Schmidt B, Kleophas W, Gillen C, Otto V, Passlick-Deetjen J, Gurland HJ. LDL hemoperfusion - a new procedure for LDL apheresis: first clinical application of an LDL adsorber compatible with human whole blood. Artif Organs 1997; 21:977-982. This is a pilot study demonstrating the clinical tolerance and biocompatibility of the DALI-apheresis system, which removes LDL from the whole blood without previous plasma separation.
18. Stefanutti C, DiGiacomo S, Vivenzio A. Comparison of different LDL-apheresis techniques. Artif Organs 1998; 21:66-71. Study of different LDL-apheresis procedures including the recent DALI system.
19. Berliner J, Leitinger N, Watson A, Huber J, Fogelman A, Navab M. Oxidized lipids in atherogenesis: formation, destruction and action. Thrombo Haemost 1997; 78:195-199. An excellent review on the role of oxidatively modified lipoproteins in atherogenesis.
20. Bräutigam C, Engelmann B, Reiss, Reinhardt U, Thiery J, Richter WO, Brosche T. Plasmalogen phospholipids in plasma lipoproteins of normolipidemic donors and patients with hypercholesterolemia treated by LDL apheresis. Atherosclerosis 1996; 119:77-88.
21. Leitinger N, Pirisch C, Blazek I, Endler G, Sinzinger H. Decreased susceptibility of low-density lipoproteins to in-vitro oxidation after dextran-sulfate LDL-apheresis treatment. Atherosclerosis 1996; 126:305-312.
22. Napoli C, Ambrosio G, Scarpato N, Corso G, Palumbo G, D'Armiento FP, et al. Decreased low-density lipoprotein oxidation after repeated selective apheresis in homozygous familial hypercholesterolemia. Am Heart J 1997; 133:585-595. This study supports previous observations that LDL-apheresis reduces the susceptibility of LDL to oxidation.
23. de Graaf J, Hak-Lemmers HL, Hectors MP, Demnacker PN, Hendriks JC, Stalenhoef AF. Enhanced susceptibility to in vitro oxidation of the low density lipoprotein subtraction in healthy subjects. Arterioscler Thromb 1991; 11:298-306.
24. Engelmann B, Bräutigam C, Thiery J. Plasmalogen phospholipids as potential protectors against lipid peroxidation of low density lipoproteins. Biochem Biophys Res Commun 1994; 204:1235-1242.
25. Hahnel D, Thiery J, Engelmann B. Plasmalogens contribute to the enhanced oxidation resistance of LDL after LDL-apheresis (HELP). European Atherosclerosis Society 70th EAS Congress, Geneva, Switzerland, 6-9 September [abstract]. This study demonstrates for the first time that the augmented resistance of LDL following LDL-apheresis is closely related to the increase in LDL plasmalogen contents.
26. Engelmann B, Bräutigam C, Kulschar R, Duhm J, Prenner E, Hermetter A, et al. Reversible reduction of phospholipid bound arachidonic acid after low density lipoprotein apheresis. Evidence for rapid incorporation of plasmalogen phosphatidylethanolamine into the red blood cell membrane. Biochim Biophys Acta 1994; 1196:154-164.
27. Zeiher AM, Drexler H, Saurbier B, Just H. Endothelium-mediated coronary blood flow modulation in humans. Effects of age, atherosclerosis, hypercholesterolemia, and hypertension. J Clin Invest 1993; 92:652-662.
28. Schachinger V, Halle M, Minners J, Berg A, Zeiher AM. Lipoprotein (a) selectively impairs receptor-mediated endothelial vasodilator function of the human coronary circulation. J Am Coll Cardiol 1997; 30:927-934. This interesting study shows for the first time that elevated lipoprotein(a) levels are associated with an impaired vasodilator capacity of the coronary circulation.
29. Anderson TJ, Meredith IT, Yeung AC, Frei B, Selwyn AP, Ganz P. The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med 1995; 332:488-493.
30. Stadler RW, Ibrahim SF, Lees RS. Peripheral vasoactivity in familial hypercholesterolemic subjects treated with heparin-induced extracorporeal LDL-precipitation (HELP). Atherosclerosis 1997; 128:241-249. This study indicated that long-term LDL-apheresis improves brachial artery vasoactivity after a 5 min forearm occlusion.
31. Tamai O, Matsuoka H, Itabe H, Wada Y, Kohno K, Imaizumi T. Single LDL apheresis improves endothelium-dependent vasodilation in hypercholesterolemic humans. Circulation 1997; 95:76-82. This interesting pilot study demonstrated an improvement in endothelium-dependent vasomotion in the human forearm vessel of patients with hypercholesterolemia by a single session of LDL-apheresis.
32. Jovin IS, Taborski U, Müller KD, Müller-Berghaus G. Improvement of myocardial perfusion after low-density lipoprotein apheresis treatment. Eur Heart J 1997; 18:531-532. This case report describes an improvement in myocardial perfusion after drastic reduction of plasma LDL and fibrinogen using the HELP procedure.
33. Aengevaeren WR, Kroon AA, Stalenhoef AF, Uijen GJ, van der Werf T. Low density lipoprotein apheresis improves regional myocardial perfusion in patients with hypercholesterolemia and extensive coronary artery disease. LDL-Apheresis Atherosclerosis Regression Study (LAARS). J Am Coll Cardiol 1996; 28:1696-1704.
34. Mellwig KP, Baller D, Gleichmann U, Moll D, Betker S, Weise R, Notohamiprodjo G. Improvement of coronary vasodilatation capacity through single LDL-apheresis. Atherosclerosis 1998; 139:173-178. This elegant study demonstrated for the first time that the acute reduction of LDL, lipoprotein(a) and fibrinogen by a single HELP-apheresis procedure leads to an improvement in coronary vasodilatation assessed by PET recording in patients with severe hypercholesterolemia and coronary artery disease.
35. Gao SZ, Schroeder JS, Alderman EL, Hunt SA, Valantine HA, Wiederhold V, Stinson EB. Prevalence of accelerated coronary artery disease in heart transplant survivors. Comparison of cyclosporine and azathioprine regimens. Circulation 1989; 80:100-105.
36. Ballantyne CM, Rodovancevic B, Farmer JA, Frazier OH, Chandler L, Payton-Ross C, et al. Hyperlipidemia after heart transplantation: report of a 6-year experience, with treatment recommendations. J Am Coll Cardiol 1992; 19:1315-1321.
37. Hunt BJ, Segal H, Yacoub M. Hemostatic changes in heart transplant recipients and their relationship to accelerated coronary sclerosis. Transplantation 1993; 55:309-315.
38. Kobashigawa JA, Katznelson S, Laks H. Johnson JA, Yeatman L, Wang XM, Chia D, et al. Effect of pravastatin on outcomes after cardiac transplantation. N Engl J Med 1995; 333:621-627.
39. Wenke K, Meiser B, Thiery J, Nagel D, von Scheidt W, Steinbeck G, et al. Simvastatin reduces graft vessel disease and mortality after heart transplantation: a four year randomized trial. Circulation 1997; 96:1398-1402. In a 4-year prospective randomized study with heart transplant recipients, simvastatin treatment led to a significant survival benefit compared with dietary measures alone.
40. Wenke K, Thiery J, Arndtz N, Meiser BM, Seidel D, Reichart B. Treatment of hypercholesterolemia and prevention of coronary artery disease after heart transplantation by combination of low dose simvastatin and HELP-LDL-apheresis. Transplant Proc 1992; 24:2674-2676.
41. Jaeger BR, Meiser B, Nagel D, Überfuhr P, Thiery J, Brandl U, et al. Aggressive lowering of fibrinogen and cholesterol in the prevention of graft vessel disease after heart transplantation. Circulation 1997; 96:154-158. This pilot study indicated that LDL-apheresis using the HELP procedure can prevent the development of graft vessel disease in heart transplant patients at high risk.
42. Park JW, Merz M, Braun P. Regression of transplant coronary artery disease during chronic low-density lipoprotein apheresis. J Heart Lung Transplant 1997; 16:290-297. This study showed for the first time that long-term LDL-apheresis using the HELP procedure can lead to regression of transplant coronary artery disease in heart transplant recipients.
43. Kroon AA, van Asten WN, Stalenhoef. Effect of apheresis of low density lipoprotein on peripheral vascular disease in hypercholesterolemic patients with coronary artery disease. Ann Intern Med 1996; 125:945-954.
44. Takagi M, Yamada T, Yamagucji H, Hashiyada H, Narimatsu M, Shibata R, et al. The role of low-density lipoprotein apheresis as postoperative care of bypass grafting for chronic arterial occlusion. Cardiovasc Surg 1996; 4:459-465.
45. Suckfüll M, Thiery J, Wimmer C, Mees K, Schorn K. Hypercholesterolemia and hyperfibrinogenemia in sudden deafness. Laryngorhinootologie 1997; 76:453-457. This study indicated that drastic lowering of plasma LDL-cholesterol and fibrinogen is an effective tool in the treatment of patients with sudden hearing loss and impaired microcirculation.