Universität zu Köln

Leebmann, Josef, Roeseler, Eberhard, Julius, Ulrich, Heigl, Franz, Spitthoever, Ralf, Heutling, Dennis, Breitenberger, Paul, Maerz, Winfried, Lehmacher, Walter, Heibges, Andreas and Klingel, Reinhard (2013). Lipoprotein Apheresis in Patients With Maximally Tolerated Lipid-Lowering Therapy, Lipoprotein(a)-Hyperlipoproteinemia, and Progressive Cardiovascular Disease Prospective Observational Multicenter Study. Circulation, 128 (24). S. 2567 - 2577. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1524-4539

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Abstract

Background-Lipoprotein(a) (Lp(a)) hyperlipoproteinemia is a major risk factor for cardiovascular disease, which is not affected by treatment of other cardiovascular risk factors. This study sought to assess the effect of chronic lipoprotein apheresis (LA) on the incidence of cardiovascular events in patients with progressive cardiovascular disease receiving maximally tolerated lipid-lowering treatment. Methods and Results-In a prospective observational multicenter study, 170 patients were investigated who commenced LA because of Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease. Patients were characterized regarding plasma lipid status, lipid-lowering drug treatment, and variants at the LPA gene locus. The incidence rates of cardiovascular events 2 years before (y(-2) and y(-1)) and prospectively 2 years during LA treatment (y+1, y+2) were compared. The mean age of patients was 51 years at the first cardiovascular event and 57 years at the first LA. Before LA, mean low-density lipoprotein cholesterol and Lp(a) were 2.56 +/- 1.04 mmol.L-1 (99.0 +/- 40.1 mg.dL(-1)) and Lp(a) 3.74 +/- 1.63 mu mol.L-1 (104.9 +/- 45.7 mg.dL(-1)), respectively. Mean annual rates for major adverse coronary events declined from 0.41 for 2 years before LA to 0.09 for 2 years during LA (P<0.0001). Event rates including all vascular beds declined from 0.61 to 0.16 (P<0.0001). Analysis of single years revealed increasing major adverse coronary event rates from 0.30 to 0.54 (P=0.001) for y(-2) to y(-1) before LA, decline to 0.14 from y(-1) to y+1 (P<0.0001) and to 0.05 from y+1 to y+2 (P=0.014). Conclusions-In patients with Lp(a)-hyperlipoproteinemia, progressive cardiovascular disease, and maximally tolerated lipid-lowering medication, LA effectively lowered the incidence rate of cardiovascular events.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leebmann, Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Roeseler, Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Julius, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Heigl, Franz UNSPECIFIED UNSPECIFIED UNSPECIFIED Spitthoever, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Heutling, Dennis UNSPECIFIED UNSPECIFIED UNSPECIFIED Breitenberger, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Maerz, Winfried UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmacher, Walter UNSPECIFIED UNSPECIFIED UNSPECIFIED Heibges, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Klingel, Reinhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-470012
DOI:	10.1161/CIRCULATIONAHA.113.002432
Journal or Publication Title:	Circulation
Volume:	128
Number:	24
Page Range:	S. 2567 - 2577
Date:	2013
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1524-4539
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LABOR-MARKET; DISABILITY; WELFARE; UNEMPLOYMENT; BODIES; WORK Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47001