The LDL-apheresis atherosclerosis regression study (Laars)

Kroon, A.A.; Aengevaeren, W.R.M.; Stalenhoef, A.F.H.

doi:10.1016/0021-9150(92)90148-a

Cited by 7 publications

(4 citation statements)

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“…It has been reported that LDL-apheresis shows angiographic arrest of the progression of coronary artery disease and induced functional improvement (12). Moreover, LDL-apheresis is known to induce regression of coronary atherosclerosis plaque in familial hyperlipidemia (13).…”

Section: Discussionmentioning

confidence: 99%

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LDL‐Apheresis Reduces P‐Selectin, CRP and Fibrinogen— Possible Important Implications for Improving Atherosclerosis

et al. 2006

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Although it is known that LDL-apheresis improves coronary artery stenosis (CAS) as well as ischemic limbs seen in patients with peripheral arterial occlusive disease (PAOD), the underlying mechanisms remain still unknown. LDL-apheresis might exert its favorable action through anti-inflammatory effects. We studied whether or not serum or plasma levels of P-selectin, high sensitivity C-reactive protein (hsCRP), monocyte chemoattractant protein-1 (MCP-1) or fibrinogen could be reduced in patients with PAOD before and after 10 sessions of LDL-apheresis. Sixteen patients (12 patients with hemodialysis, HD) with PAOD were enrolled in the present study. LDL-apheresis was carried out 10 times (treated plasma of 3000 mL) over 5 weeks. Serum levels of P-selectin were significantly reduced from 516 +/- 153 to 290 +/- 52 ng/mL before and after 10-sessions of LDL-apheresis, respectively (P < 0.05). Likewise, serum levels of hsCRP decreased from 9.118 +/- 2.649 to 5.587 +/- 2.445 mg/L (P < 0.01); and plasma fibrinogen levels statistically decreased from 196 +/- 9.82 to 149 +/- 7.97 mg/dL (P < 0.01), whereas serum levels of MCP-1 were not significantly changed. The favorable actions of LDL-apheresis might include anti-inflammatory effects, which could lead to an improvement of CAS and PAOD. Moreover, this intervention might be applicable for patients with atherosclerotic cardiovascular disorders, particularly in patients with HD.

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Section: Discussionmentioning

confidence: 99%

“…From a prospective, open, randomized study, we also know that LDL-apheresis retards the progression of coronary atherosclerosis (the LDL-Apheresis Atherosclerotic Regression Study: LAARS) (12). Furthermore, it has been reported that in the LAC-MART study (13), LDL-apheresis also improved coronary artery stenosis (CAS).…”

Section: Introductionmentioning

confidence: 99%

LDL‐Apheresis Reduces P‐Selectin, CRP and Fibrinogen— Possible Important Implications for Improving Atherosclerosis

et al. 2006

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“…Weiterhin fiel den Autoren der Studie auf, dal3 in der Anfangsphase die Inzidenz der Myokardinfarkte in der medikament6s behandelten Patientengruppe h0her war als in der Apheresegruppe [9]. Weiterhin fiel den Autoren der Studie auf, dal3 in der Anfangsphase die Inzidenz der Myokardinfarkte in der medikament6s behandelten Patientengruppe h0her war als in der Apheresegruppe [9].…”

Section: Klinische Beobachtungen Die Fª Eine Plaquestabilisierung Beunclassified

Plaquestabilisierung durch LDL-Apherese?

Schuff‐Werner

Schettler

1999

Herz

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Vulnerable lipid-rich plaques are often the cause of atherothrombotic events leading to unstable angina and/or to acute myocardial infarction. Consequent long-term LDL-lowering by drugs as shown by the most important intervention studies lead to plaque stabilization as shown by the significant reduction of myocardial reinfarction. First studies in patients undergoing regular extracorporeal LDL-elimination indicate, that clinical events might be reduced much earlier as by drug therapy alone: A more than 60% reduction of LDL at weekly intervals is obviously associated with an early regression of lipid-rich vascular lesions. LDL-apheresis, mainly by HELP and by double filtration reduces the shear-stress of the flowing blood on vulnerable plaques either by its effect on plasmaviscosity and/or on the vasomotoric reserve thus leading to a lower peripheral arterial resistance. Furthermore oxidized LDL, which might counteract plaque stabilisation by its inflammatory effects are effectively eliminated by LDL-apheresis. The affinity of different LDL-apheresis procedures to coagulation factors normalizes hypercoagulatory states thus avoiding atherothrombotic events at the site of vulnerable or erosive plaques.

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“…In the last years, lipid apheresis has been shown to be an efficient tool in lowering not only pharmacotherapy-resistant elevated plasma low-density lipoprotein (LDL) levels but also in reducing the incidence of cardiovascular events. Clinical trials with a duration from 1 to 9 years documented a stabilization and even regression of established coronary atherosclerosis [1][2][3]. Moreover, LDL apheresis improved regional myocardial perfusion [4].…”

Section: Introductionmentioning

confidence: 99%