TREATMENT OF SEVERE HYPERLIPIDEMIA - 6 YEARS EXPERIENCE WITH LOW-DENSITY-LIPOPROTEIN APHERESIS

In total, 30 patients suffering from familial hypercholesterolemia, re sistant to diet and lipid-lowering drugs, were treated for up to 6 yea rs (3.6 +/- 1.6; range, 0.2-6.8 years) with low-density lipoprotein (L DL) apheresis. Three different systems were used; the dextran sulfate adsorption system (Kaneka) for 27 of 30 patients, the immunoadsorption system from Baxter for 2 of 30 patients, and the immunoadsorption sys tem with special lipoprotein(a) (Lp[a]) columns from Lipopak for one p atient. Prior to the LDL apheresis, 23 of 30 patients suffered from co ronary heart disease. Twenty of 23 patients suffered intermittently fr om symptoms of angina excertional dyspnea, and claudication. With LDL apheresis, reductions of 47% for total cholesterol, 49% for LDL, 26% f or Lp(a), and 40% for triglycerides were reached. Severe side effects such as shock or allergic reactions were very rare (0.55%). In the cou rse of treatment with LDL apheresis, an improvement in general well-be ing and increased performance were experienced in 27 of 30 patients. A reduction of nitrate medication between 60 and 100% was observed in 1 7 of 23 patients. The present data clearly demonstrate that treatment with LDL apheresis in patients suffering from severe familial hyperlip idemia, resistant to maximum conservative therapy, is very effective a nd safe even over long periods of time.