COMPARISON OF EFFECTS OF LONG-TERM LIPID- LOWERING DRUG-THERAPY AND OF ITS COMBINATION WITH APHERESIS OF BLOOD-PLASMA LIPIDS ON THE STATE OF CORONARY VESSELS IN PATIENTS WITH HIGH HYPERCHOLESTEROLEMIA AND ISCHEMIC-HEART-DISEASE

Effects of long-term medical lipid lowering therapy (lovastatin, long acting nicotinic acid) and its combination with extracorporeal removal of lipids from plasma (plasmapheresis, immunoadsorption) once in 2 we eks on the state of atherosclerotic lesions of coronary arteries was s tudied in 21 patients with high hypercholesterolemia and ischemic hear t disease. Visual and quantitative analysis of repeat coronary angiogr ams was used. Intervals between initial and final angiography varied f rom 16 to 37 months (average 21 month). Before therapy low density lip oprotein cholesterol level in the group of drug treatment (13 patients ) was 7,25 mmol/l, in the group of combination treatment (8 patients) - 9,17 mmol/l, high density lipoprotein cholesterol levels were 1,03 m mol/l and 1.02 mmol/l, respectively. In both groups therapy led to low ering of low density lipoprotein cholesterol level by 13,6% (drugs) an d 45% (commination therapy), respectively. High density lipoprotein le vel rose by 20,8% only in the group of drug treatment. Stabilization o f coronary atherosclerotic lesions was observed in 10 patients (77%) o f the drug group and in 5 (63%) of the combination therapy group while progression occurred in 3 (23%) and 3 (37%) patients, respectively. T hus despite different lipid lowering effect of therapy in most patient s of both groups stabilization of coronary atherosclerosis was observe d.