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Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease: Prospective Observational Multicenter Study
Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients w...
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| Published in: | Circulation (New York, N.Y.) N.Y.), 2013-12, Vol.128 (24), p.2567-2576 |
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| container_end_page | 2576 |
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| container_title | Circulation (New York, N.Y.) |
| container_volume | 128 |
| creator | LEEBMANN, Josef ROESELER, Eberhard KLINGEL, Reinhard JULIUS, Ulrich HEIGL, Franz SPITTHOEVER, Ralf HEUTLING, Dennis BREITENBERGER, Paul MAERZ, Winfried LEHMACHER, Walter HEIBGES, Andreas |
| description | Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment.
In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56±1.04 mmol·L(-1) (99.0±40.1 mg·dL(-1)) and Lp(a) 3.74±1.63 µmol·L(-1) (104.9±45.7 mg·dL(-1)), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.113.002432 |
| format | article |
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In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56±1.04 mmol·L(-1) (99.0±40.1 mg·dL(-1)) and Lp(a) 3.74±1.63 µmol·L(-1) (104.9±45.7 mg·dL(-1)), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (P<0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (P<0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (P=0.001) for y-2 to y-1 before LA, decline to 0.14 from y-1 to y+1 (P<0.0001) and to 0.05 from y+1 to y+2 (P=0.014).
In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.
https://drks-neu.uniklinik-freiburg.de. Unique identifier: DRKS00003119.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.113.002432</identifier><identifier>PMID: 24056686</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Component Removal - methods ; Cardiology. Vascular system ; Cardiovascular Diseases - epidemiology ; Cholesterol, LDL - blood ; Coronary heart disease ; Disease Progression ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Disorders of blood lipids. Hyperlipoproteinemia ; Female ; Follow-Up Studies ; Germany ; Heart ; Humans ; Hyperlipoproteinemias - blood ; Hyperlipoproteinemias - therapy ; Hypolipidemic Agents - therapeutic use ; Incidence ; Lipoprotein(a) - blood ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Treatment Outcome</subject><ispartof>Circulation (New York, N.Y.), 2013-12, Vol.128 (24), p.2567-2576</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c291t-ba9395394c3aa2357a85637b8bb3e0a40d1e83ebb368b8976f4342bb3e1dbf4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28032648$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24056686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LEEBMANN, Josef</creatorcontrib><creatorcontrib>ROESELER, Eberhard</creatorcontrib><creatorcontrib>KLINGEL, Reinhard</creatorcontrib><creatorcontrib>JULIUS, Ulrich</creatorcontrib><creatorcontrib>HEIGL, Franz</creatorcontrib><creatorcontrib>SPITTHOEVER, Ralf</creatorcontrib><creatorcontrib>HEUTLING, Dennis</creatorcontrib><creatorcontrib>BREITENBERGER, Paul</creatorcontrib><creatorcontrib>MAERZ, Winfried</creatorcontrib><creatorcontrib>LEHMACHER, Walter</creatorcontrib><creatorcontrib>HEIBGES, Andreas</creatorcontrib><creatorcontrib>Pro(a)LiFe Study Group</creatorcontrib><title>Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease: Prospective Observational Multicenter Study</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment.
In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56±1.04 mmol·L(-1) (99.0±40.1 mg·dL(-1)) and Lp(a) 3.74±1.63 µmol·L(-1) (104.9±45.7 mg·dL(-1)), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (P<0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (P<0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (P=0.001) for y-2 to y-1 before LA, decline to 0.14 from y-1 to y+1 (P<0.0001) and to 0.05 from y+1 to y+2 (P=0.014).
In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.
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Hyperlipoproteinemia</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Germany</subject><subject>Heart</subject><subject>Humans</subject><subject>Hyperlipoproteinemias - blood</subject><subject>Hyperlipoproteinemias - therapy</subject><subject>Hypolipidemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Lipoprotein(a) - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNpVUV1v0zAUtRCIlcFfQOYBaUjL8FfSZG9RGLRSRifoxGN0k9xuRm4SbKcjv5E_hasWBk_WuT7nfpxDyBvOLjhP-Pti-aW4LfP1cvU5X-ShJi8YE0qKJ2TGY6EiFcvsKZkxxrJoLoU4IS-c-x5gIufxc3IiFIuTJE1m5Feph36wvUfd0Xy4R4tOOxrADXiNnXf0m_b39Bp-6i0YM9F1b9CCx5YGqW6jsn9Aq7s7ug5iGKZz-k_LM3gXLaYBrXms4VbDOYWupTe2vwvznN4hLcC2ut-Ba0YDln7QDsHh5Z7jBmz8nrOqHdpd2KvvwNDr0XjdhBXR0q9-bKeX5NkGjMNXx_eU3H68WheLqFx9WhZ5GTUi4z6qIZNZMEg1EkDIeA5pHHyp07qWyECxlmMqMaAkrdNsnmyUVGL_ydt6o1CekrND33DQjxGdr7baNWgMdNiPruIqyUSwWohAzQ7UJpzhLG6qwQYf7VRxVu2zrP7PMtRkdcgyaF8fx4z1Ftu_yj_hBcLbIyG4BmZjoWu0e-SlTIpEpfI3gDSvYQ</recordid><startdate>20131217</startdate><enddate>20131217</enddate><creator>LEEBMANN, Josef</creator><creator>ROESELER, Eberhard</creator><creator>KLINGEL, Reinhard</creator><creator>JULIUS, Ulrich</creator><creator>HEIGL, Franz</creator><creator>SPITTHOEVER, Ralf</creator><creator>HEUTLING, Dennis</creator><creator>BREITENBERGER, Paul</creator><creator>MAERZ, Winfried</creator><creator>LEHMACHER, Walter</creator><creator>HEIBGES, Andreas</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131217</creationdate><title>Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease: Prospective Observational Multicenter Study</title><author>LEEBMANN, Josef ; ROESELER, Eberhard ; KLINGEL, Reinhard ; JULIUS, Ulrich ; HEIGL, Franz ; SPITTHOEVER, Ralf ; HEUTLING, Dennis ; BREITENBERGER, Paul ; MAERZ, Winfried ; LEHMACHER, Walter ; HEIBGES, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c291t-ba9395394c3aa2357a85637b8bb3e0a40d1e83ebb368b8976f4342bb3e1dbf4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood Component Removal - methods</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cholesterol, LDL - blood</topic><topic>Coronary heart disease</topic><topic>Disease Progression</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Disorders of blood lipids. Hyperlipoproteinemia</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Germany</topic><topic>Heart</topic><topic>Humans</topic><topic>Hyperlipoproteinemias - blood</topic><topic>Hyperlipoproteinemias - therapy</topic><topic>Hypolipidemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>Lipoprotein(a) - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LEEBMANN, Josef</creatorcontrib><creatorcontrib>ROESELER, Eberhard</creatorcontrib><creatorcontrib>KLINGEL, Reinhard</creatorcontrib><creatorcontrib>JULIUS, Ulrich</creatorcontrib><creatorcontrib>HEIGL, Franz</creatorcontrib><creatorcontrib>SPITTHOEVER, Ralf</creatorcontrib><creatorcontrib>HEUTLING, Dennis</creatorcontrib><creatorcontrib>BREITENBERGER, Paul</creatorcontrib><creatorcontrib>MAERZ, Winfried</creatorcontrib><creatorcontrib>LEHMACHER, Walter</creatorcontrib><creatorcontrib>HEIBGES, Andreas</creatorcontrib><creatorcontrib>Pro(a)LiFe Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LEEBMANN, Josef</au><au>ROESELER, Eberhard</au><au>KLINGEL, Reinhard</au><au>JULIUS, Ulrich</au><au>HEIGL, Franz</au><au>SPITTHOEVER, Ralf</au><au>HEUTLING, Dennis</au><au>BREITENBERGER, Paul</au><au>MAERZ, Winfried</au><au>LEHMACHER, Walter</au><au>HEIBGES, Andreas</au><aucorp>Pro(a)LiFe Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease: Prospective Observational Multicenter Study</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2013-12-17</date><risdate>2013</risdate><volume>128</volume><issue>24</issue><spage>2567</spage><epage>2576</epage><pages>2567-2576</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment.
In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y-2 and y-1) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56±1.04 mmol·L(-1) (99.0±40.1 mg·dL(-1)) and Lp(a) 3.74±1.63 µmol·L(-1) (104.9±45.7 mg·dL(-1)), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (P<0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (P<0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (P=0.001) for y-2 to y-1 before LA, decline to 0.14 from y-1 to y+1 (P<0.0001) and to 0.05 from y+1 to y+2 (P=0.014).
In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.
https://drks-neu.uniklinik-freiburg.de. Unique identifier: DRKS00003119.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>24056686</pmid><doi>10.1161/CIRCULATIONAHA.113.002432</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Blood and lymphatic vessels Blood Component Removal - methods Cardiology. Vascular system Cardiovascular Diseases - epidemiology Cholesterol, LDL - blood Coronary heart disease Disease Progression Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Disorders of blood lipids. Hyperlipoproteinemia Female Follow-Up Studies Germany Heart Humans Hyperlipoproteinemias - blood Hyperlipoproteinemias - therapy Hypolipidemic Agents - therapeutic use Incidence Lipoprotein(a) - blood Male Medical sciences Metabolic diseases Middle Aged Prospective Studies Retrospective Studies Risk Factors Treatment Outcome |
| title | Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease: Prospective Observational Multicenter Study |
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