M. Walzl et al., HEPARIN-INDUCED EXTRACORPOREAL LDL PRECIP ITATION (HELP) - A NEW THERAPEUTIC APPROACH IN CEREBRAL MULTIINFARCT DEMENTIA, Nervenarzt, 64(10), 1993, pp. 648-652
High fibrinogen levels have been assessed in cerebrovascular disease w
ith a direct relationship to blood rheology. Heparin-induced extracorp
oreal LDL precipitation (HELP) is a method that effectively reduces fi
brinogen and lipoproteins at the same time, thus improving the hemorhe
ologic pattern. We studied 45 patients with cerebral multiinfarct deme
ntia. After computer-randomization 30 patients received a HELP treatme
nt, while the remaining 15 patients served as controls. HELP produced
an immediate and statistically significant reduction on parameters rel
evant to hemorheology, such as fibrinogen (P<0.001), total cholesterol
, low-density lipoprotein, triglycerides (P<0.0001 each) and whole blo
od viscosity (at high and low shear rate) as well as plasma viscosity
and red cell transit time (P<0.01 each). The treated group showed impr
ovement after HELP (P<0.05 for each test) on the Mathew Neurological S
cale, Mini Mental State Examination and Activities-of-Daily-Living Tes
t and also relative to the untreated controls (P<0.05 each). These res
ults may be regarded as a basis for some reflections about new hemorhe
ological interventions in cases of cerebral multiinfarct dementia.