Direct adsorption of LDL cholesterol - one center experience

Tomic-Naglic, Dragana; Manojlovic, Mia; Mitrović, Milena; Prodanovic, Jovana; Bajkin, Ivana; Pejakovic, Sladjana

doi:10.2298/sarh211017095t

Cited by 1 publication

(1 citation statement)

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“…LDL apheresis has proven to be an effective therapeutic solution, since literature data and clinical experience suggest that it can reduce Lp(a) plasma levels by up to 60% [ 73 ]. Moreover, LDL apheresis has been shown to reduce the risk of major adverse CV events, defined as CV death, coronary bypass surgery, nonfatal myocardial infarction, percutaneous coronary intervention, or stenting, by up to 86%, as well as to reduce the annual risk of myocardial infarction by up to 97% [ 73 , 74 ]. Additionally, because it is mostly apo(a) that contributes to the pathogenic potential of Lp(a), new therapeutic approaches focused on reducing the production of this apoprotein in liver hepatocytes are being explored.…”

Section: Therapeutic Optionsmentioning

confidence: 99%

Lipoprotein(a): Role in atherosclerosis and new treatment options

et al. 2023

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Atherosclerosis is a chronic process characterized by inflammation and the progressive accumulation of inflammatory cells and lipids in the blood vessel wall, resulting in narrowing of the blood vessel’s circumference. Treatment of people with dyslipidemia aims to reduce the risk of developing atherosclerotic disease and prevent major adverse cardiovascular events (MACE). The results of previous studies indicated that lipoprotein(a) (Lp(a)) is a critical causal factor in the estimated risk of developing a cardiovascular (CV) incident even after achieving desirable low-density lipoprotein (LDL) cholesterol levels. Lp(a) is a low-density lipoprotein particle, like LDL cholesterol. The levels of Lp(a) in plasma are genetically determined. Lp(a) catabolism is still controversial. The pathogenic potential of Lp(a) can be divided into three categories: promotion of plaque formation, thrombogenicity, and proinflammatory effects. Lp(a) levels above the 75th percentile reduced the risk of aortic valve stenosis and myocardial infarction, whereas higher levels (above 90th percentile) were associated with an increased risk of heart failure. However, no hypolipidemic agents have been approved for targeted use in patients with high Lp(a) levels. There are insufficient randomized controlled trials assessing CV outcomes that would support the evidence that current treatment options, which effectively lower Lp(a) levels, also effectively prevent CV event. However, according to some studies, there is strong evidence that better CV outcome is one of the benefits of such therapy. The results of ongoing clinical trials are eagerly awaited.

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Section: Therapeutic Optionsmentioning

confidence: 99%