HEPARIN-INDUCED EXTRACORPOREAL LDL PRECIP ITATION (HELP) - A NEW THERAPEUTIC APPROACH IN CEREBRAL MULTIINFARCT DEMENTIA

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.