Document Detail


Effect of specific lipoprotein(a) apheresis on coronary atherosclerosis regression assessed by quantitative coronary angiography.
MedLine Citation:
PMID:  23357149     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIM: To evaluate the effect of specific lipoprotein(a) [Lp(a)] apheresis on coronary atherosclerosis progression in coronary heart disease (CHD) patients with elevated Lp(a) levels.
METHODS: A total of 30 subjects (mean age 53.5 ± 8.3 years, 70% male) with CHD verified by angiography, Lp(a) > 50 mg/dL, and low density lipoprotein cholesterol (LDL-C) ≤ 2.5 mmol/L on chronic statin treatment were prospectively evaluated for 18 months. Patients were allocated to receive specific Lp(a) apheresis, which was carried out weekly with Lp(a) Lipopak(®) columns (POCARD Ltd., Russia) (n = 15), or atorvastatin only (n = 15). Blinded quantitative coronary angiography analyses of percent diameter stenosis and minimal lumen diameter (MLD) were performed at baseline and after the 18-month treatment period.
RESULTS: By the single specific Lp(a) apheresis procedure, Lp(a) level decreased by an average of 73 ± 12% to a mean of 29 ± 16 mg/dL, and mean Lp(a)-corrected LDL-C decreased by 7% to a mean of 1.4 mmol/L. Median percent diameter stenosis was reduced by -2.0 (95% confidence interval [CI], -5.0-0.0) with apheresis (p < 0.01 in comparison with baseline), and increased by 3.5 (0.0-6.9) with atorvastatin (p < 0.001 between the groups). The effect on MLD was more favorable with apheresis than with atorvastatin: 0.20 ± 0.39 mm, as compared with 0.01 ± 0.34 mm, p = 0.04. Lp(a) apheresis had greater efficacy regarding the amount of regressed/stabilized coronary segments than atorvastatin alone in the majority of patients (chi-square test 13.61, p < 0.005).
CONCLUSION: Specific Lp(a) apheresis for 18 months produced coronary atherosclerosis regression in stable CHD patients with high Lp(a) levels and reached LDL-C goals.
Authors:
Maya S Safarova; Marat V Ezhov; Olga I Afanasieva; Yuriy G Matchin; Ruslan V Atanesyan; Irina Yu Adamova; Elena A Utkina; Gennadiy A Konovalov; Sergei N Pokrovsky
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Atherosclerosis. Supplements     Volume:  14     ISSN:  1878-5050     ISO Abbreviation:  Atheroscler Suppl     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100973461     Medline TA:  Atheroscler Suppl     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  93-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Cardiology Research Center 15A, 3rd Cherepkovskaya Street, 121552 Moscow, Russia. Electronic address: Dr.Safarova@gmail.com.
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