Abstract

BackgroundSince 2005 an interdisciplinary German apheresis working group has been established by members of both German Societies of Nephrology and of Lipidologists and completed the data set for the registry according to the current guidelines and the German indication guideline for apheresis in 2009. In 2011 the German Lipoprotein Apheresis Registry (GLAR) was launched and data are available over nearly 5 years now.Methods and resultsDuring the time period 2012–2016, 71 German apheresis centers collected retrospective and prospective observational data of 1435 patients undergoing lipoprotein apheresis (LA) treatment of high LDL-C levels and/or high Lp (a) levels suffering from cardiovascular disease (CVD) or progressive CVD. A total of 15,527 completely documented LA treatments were entered into the database. All patients treated by LA showed a median LDL-C reduction rate of 67.5%, and a median Lp (a) reduction rate of 71.1%. Analog to the Pro(a)LiFe pattern, patient data were analyzed to the incidence rate of coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y‑1) and prospectively two years on LA treatment (y + 1 and y + 2). During two years of LA treatment a MACE reduction of 78% was observed. In the years considered, side effects of LA treatment were low (5.9%) and mainly comprised puncture problems.ConclusionsThe data generated by the GLAR shows that LA lowers the incidence rate of cardiovascular events in patients with high LDL-C and/or high Lp (a) levels, progressive CVD, and maximally tolerated lipid lowering medication. In addition, LA treatments were found to be safe with a low rate of side effects.

Highlights

  • Up to the early 80s of the last century, no adequate lipid lowering therapy was available for patients suffering from progressive cardiovascular diseases induced by severe hy-Vascular Risks, AGAPLESION Markus Hospital, Frankfurt, Germany 9 Scientific Institute for Nephrology (WiNe), Düsseldorf, Germany 10 Medizinische Klinik und Poliklinik 4, Universität München, Munich, GermanyK perlipidemia, mainly high LDL-cholesterol (LDL-C) levels or Lp (a)-hyperlipoproteinemia (Lp (a)-HLP (a)) [1]

  • German apheresis centers collected retrospective and prospective observational data of 1435 patients undergoing lipoprotein apheresis (LA) treatment of high LDL-C levels and/or high Lp (a) levels suffering from cardiovascular disease (CVD) or progressive CVD

  • At the same time an interdisciplinary German apheresis working group was established by members of both German Societies of Nephrology and Lipidologists, who developed an indication for LA with respect to current cardiovascular guidelines and scientific knowledge and initiated the establishment of the German Lipoprotein Apheresis Registry (GLAR) [7, 8]

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Summary

Introduction

During the 80s and 90s many trials with respect to therapy by different statins were performed They showed that in patients suffering from severe hypercholesterolemia a decrease of LDL-C is associated with a decrease of cardiovascular events in both primary and secondary prevention [3]. At the same time an interdisciplinary German apheresis working group was established by members of both German Societies of Nephrology and Lipidologists, who developed an indication for LA with respect to current cardiovascular guidelines and scientific knowledge and initiated the establishment of the German Lipoprotein Apheresis Registry (GLAR) [7, 8]. In 2011 the German Lipoprotein Apheresis Registry (GLAR) was launched and data are available over nearly 5 years

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