Abstract
Background/aims To assess LDL-apheresis efficacy to lower Lp(a) and to compare the effects of Usual Medical Care (UMC) a 12-months study was carried out. The incidence of new coronary artery disease (CAD) events/need of revascularization, was also monitored. Methods Twenty-one patients with hyperLp(a)lipidemia and angiographically documented CAD were randomly assigned to LDL-apheresis every week, or the UMC. Results LDL-apheresis group, averaged an Lp(a) reduction of 57.8 ± 9.5% vs. basal values ( P < 0.001). In the UMC group Lp(a) increased in 1 year to 14.7 ± 36.5% ( P = 0.66). Stepwise multivariate regression analysis for predictors of Lp(a) including: type of treatment, smoking, hypertension, age, age at first cardiovascular event, initial Lp(a), LDL, and BMI values, was performed. Only the type of treatment was co-related ( P < 0.001): Lp(a) variation (beta) = 0.863. The model has R2 adjusted relative risk of 0.725. Conclusion LDL-apheresis could be the first line treatment of isolated hyperLp(a)lipidemia when CAD is established. New CAD events/cardiac interventions were not observed.
Published Version
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