LDL-APHERESIS SIGNIFICANTLY REDUCES URINARY APO(A) EXCRETION

Increased plasma Lp(a) is an established risk factor for atheroscleros is. We recently described the presence of apo(a) fragments in urine an d the significant correlation between urinary apo(a) concentrations an d plasma Lp(a). Here we investigated urinary apo(a) in patients suffer ing from familial hypercholesterolaemia (FH), treated with LDL apheres is. Before treatment, plasma Lp(a) levels and urinary apo(a) normalize d to creatinine were >2-fold increased in FH patients (P < 0.0001) as compared to controls. LDL-apheresis led to a reduction of plasma Lp(a) by 75% and a concommittant immediate reduction of urinary apo(a) by 4 5%. We conclude that a steady state condition for urinary apo(a) is ra pidly achieved via LDL-apheresis.