Document Detail


Retrospective analysis of long-term lipid apheresis at a single center.
MedLine Citation:
PMID:  20438535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively analyzed 10 906 lipid apheresis sessions (heparin-induced lipoprotein precipitation, direct adsorption of lipoproteins, double filtration plasmapheresis, dextran sulfate adsorption, and immunoadsorption) in 38 patients who were consecutively treated in our department during the last 20 years. The incidences of major cardiovascular events (MACE) (death, cerebrovascular accident, myocardial infarction, limb amputation, and renal vascular involvement) were taken separately as primary end-points or as a combined end-point. The time-course of secondary end-points (coronary and extracranial status of arteries, left ventricular function, occlusive artery disease, and calculated glomerular filtration rate [cGFR]) were also evaluated, as well as the extent of the reduction in plasma lipids and lipoproteins and the incidence of therapy associated side-effects. MACE decreased from 7.02% events per patient per year at the start of lipid apheresis to 1.17% during lipid apheresis and the rate of myocardial revascularization decreased from 22.8% to 3.8% per patient per year. Classical (diabetes mellitus, arterial hypertension, and smoking history), as well as novel risk factors (cGFR < 60 mL/min, statin withdrawal, mixed hyperlipoproteinemia, and elevated lipoprotein (a)) were associated with an elevated risk for MACE. All applied methods had comparable effects. All lipid apheresis methods proved to be safe and suitable for long-term treatment. The present data demonstrate that treatment with lipid apheresis is very effective and leads to long-term reduction in cardiovascular mortality and morbidity.
Authors:
Michael J Koziolek; Ulrich Hennig; Antonia Zapf; Carsten Bramlage; Clemens Grupp; Victor W Armstrong; Frank Strutz; Gerhard A Müller
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  14     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  143-52     Citation Subset:  IM    
Affiliation:
Departments of Nephrology and Rheumatology, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen, Germany. mkoziolek@med.uni-goettingen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Component Removal / adverse effects,  methods*
Cardiovascular Diseases / etiology,  mortality,  prevention & control*
Dextran Sulfate / chemistry
Filtration
Follow-Up Studies
Heparin / chemistry
Humans
Hyperlipidemias / complications,  therapy*
Immunosorbent Techniques
Lipoproteins / blood
Male
Middle Aged
Plasmapheresis / adverse effects,  methods*
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Lipoproteins; 9005-49-6/Heparin; 9042-14-2/Dextran Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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