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LDL-apheresis: results of longterm treatment and vascular outcome

  • Christiane Keller
    Correspondence
    Correspondence to: Professor Dr. Christiane Keller, Medizinische Poliklinik der Universität, Pettenkoferstr. 8a, D-8000 München 2, F.R.G. Tel.: 089-51603511; Fax: 089-52 22 95.
    Affiliations
    Medizinische Poliklinik der Universität, München, F.R.G.
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      Abstract

      LDL-apheresis (immunoabsorption, heparin precipitation (HELP), dextran sulfate cellulose binding (DSC) or filtration) is a potent therapeutic tool in familial hypercholesterolemia (FH) to eliminate LDL-cholesterol, Lp(a) or fibrinogen from the circulation and improve blood rheology. Repetitive use can deplete the cholesterol pool between 40 and 80%. As first reports showed, progression of coronary atherosclerosis can be stopped and sometimes regression can be induced. So far the domain of plasmapheresis was homozygous familial hypercholesterolemia. With several apheresis methods now available, it seems timely to define the indication of plasma therapy for heterozygous FH and the place of this potent therapeutic tool in primary and secondary prevention of atherosclerotic coronary heart disease in patients suffering from severe hypercholesterolemia resistant to diet and/or drug therapy.

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