State of the art of low-density lipoprotein apheresis in the year 2003.

摘要: Low-density lipoprotein (LDL) apheresis is a last-resort treatment for hypercholesterolemic patients resistant to conservative lipid-lowering therapy. In the extracorporeal circuit, LDL, Lp(a) and coagulation factors are selectively eliminated, while beneficial proteins like high-density lipoprotein, albumin immunoglobulins returned patient. Clinical effects of LDL comprise improvement symptoms angina exercise tolerance, reduction clinical coronary events unstable angina, need angioplasty or bypass operation, myocardial infarction ultimately mortality. The atherogenic lipoproteins by (LA) positively influences hemorheology, endothelial function reserve. controlled LAARS, LA significantly improved electrocardiographic signs ischemia in treadmill test. angiographically trials such as LARS L-CAPS, progression lesions was observed; favorable cases, regression stenoses could be documented. addition, morphology trial, decreased plaque area. Hokuriku trial documented 72% decrease (MACE) group vs. controls treated only statins. longitudinal studies, incidence MACE after regular compared with preapheresis period same patients. Apart from heart disease, recent studies indicate positive effect also on carotid artery peripheral vascular disease. Prospective randomized showed cascade filtration age-related macular degeneration heparin-induced precipitation acute inner ear deafness.