Document Detail

Extracorporeal LDL cholesterol elimination (25 years of experience in CZ).
MedLine Citation:
PMID:  20129368     Owner:  NLM     Status:  In-Data-Review    
In the Czech Republic the therapy of severe familial hypercholesterolemia (FH) by extracorporeal elimination using LDL-apheresis (immunoadsorption) and hemorheopheresis is concentrated into one center. The authors evaluate the long-term therapy (3-12 years, median 7,25) in 12 patients with FH - 3 homozygous, 9 heterozygous; Fredrickson type IIa, IIb (treated: 9 by LDL-apheresis and 3 by hemorheo-pheresis). Immunoapheretic interventions decrease LDL-cholesterol, ApoB and even Lp(a) by about 82 +/- 1; 73 +/- 13; 82 +/- 19 %, respectively. Selected non-invasive methods are important for a long-term and repeated follow-up. Carotid intima-media thickness showed improvement or stagnation in 75% of the patients. The level of some adhesive molecules, cytokines, endoglin and some coagulation functions were measured, but no universally accepted biomarkers informing of the actual activity of the disease were found to predict and plan the therapy. A program for procedure planning with the use of Microsoft((R)) Excel for Windows((R)) was developed. In summary, LDL-apheresis and hemorheopheresis substantially lower LDL-cholesterol in FH. Our experience with long-term therapy also shows good tolerance and a small number of complications (5,6% of clinically irrelevant side-effects). Hemorheopheresis may improve blood flow in microcirculation in familial hypercholesterolemia and also in some other disorders of microcirculation.
M Blaha; Z Zadak; V Blaha; C Andrys; E Havel; P Vyroubal; M Blazek; S Filip; M Lanska; J Maly
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Atherosclerosis. Supplements     Volume:  10     ISSN:  1878-5050     ISO Abbreviation:  Atheroscler Suppl     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100973461     Medline TA:  Atheroscler Suppl     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  17-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
2nd Department of Internal Medicine, Charles University School of Medicine and Teaching Hospital, Hradec Králové,CZ.
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