LDL-APHERESIS IN 2 PATIENTS WITH EXTREMELY ELEVATED LIPOPROTEIN(A) LEVELS

Hyperlipidemia and elevated lipoprotein (a) [Lp(a)] levels have been l inked to the development and progression of premature atherosclerosis. Two male caucasian patients (36 and 42 years old) with heterozygous f amilial hypercholesterolemia and extremely elevated Lp(a) concentratio ns, resistant to diet regimen and lipid lowering drugs, were treated w ith LDL-apheresis for 55 months (liposorber system, Kaneka(R), Japan) and 15 months (immunoadsorption system, special Lp(a) columns, Lipopak (R), Pocard, Russia). Lp(a) dropped on average by 50%, total cholester ol by 27%, LDL-cholesterol by 42%, triglycerides by 43% and the fibrin ogen concentration by 16%. Prior to treatment both patients had suffer ed three myocardial infarctions. Four and six coronary angiographies w ith two and four percutaneous transluminal angioplasties (PTCA) were n ecessary. Since the treatment with LDL-apheresis neither myocardial in farctions nor cardiac complaints been observed, and both patients have reported better performance. Available data suggest that LDL-apheresi s may be effective in the treatment of patients with extremely high Lp (a) concentration.