Highlights
- •The UK Lipoprotein Apheresis (LA) Registry was established in 2011.
- •Between 2011 and 2017 data was entered retrospectively and prospectively by seven LA centres in the UK for 151 patients.
- •The mean reduction in interval mean LDL-C from the pre-procedure baseline was 43.14% and 37.95% for Lp(a).
- •There was a 62.5% reduction in major adverse cardiovascular events (MACE) following introduction of LA.
Abstract
Background and aims
In 2008, the National Institute of Health and Care Excellence in the UK recommended
that patients undergoing lipoprotein apheresis (LA) should be included in an anonymised
registry. The UK Lipoprotein Apheresis Registry was subsequently established in 2011.
Methods
Between 2011 and 2017, data was entered retrospectively and prospectively by seven
LA centres in the UK for 151 patients. Twenty-two patients were involved in a research
study and were therefore excluded from the analysis. Observational data was analysed
for the remaining 129 patients.
Results
Most patients had heterozygous familial hypercholesterolaemia (HeFH) (45.0%); 23.3%
had homozygous FH (HoFH); 7.8% had hyper-lipoproteinaemia (a) (Lp(a)) and 24.0% had
other forms of dyslipidaemia. Detailed treatment data is available for 63 patients
relating to 348 years of LA treatment. The number of years of treatment per patient
ranged from 1 to 15. The mean reduction in interval mean LDL-C from the pre-procedure
baseline was 43.14%. The mean reduction in interval mean Lp(a) from baseline was 37.95%.
The registry data also shows a 62.5% reduction in major adverse cardiovascular events
(MACE) between the 2 years prior to, and the first 2 years following introduction
of LA.
Conclusions
The data generated by the UK Lipoprotein Apheresis Registry demonstrates that LA is
a very efficient method of reducing LDL-C and Lp(a) and lowers the incidence rate
of MACE. LA is an important tool in the management of selected patients with HoFH
and drug-resistant dyslipidaemias.
Graphical abstract
Graphical Abstract
Keywords
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Article Info
Publication History
Published online: September 12, 2019
Accepted:
September 12,
2019
Received in revised form:
September 10,
2019
Received:
June 3,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Corrigendum to “Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989–2017” [Atherosclerosis 290 (November 2019) 44–51]AtherosclerosisVol. 294
- PreviewThe Authors regret that there is a repetitive error in Table 4 with regards to the use of the term “baseline”. Under the Factors TC, LDL-C and Lp(a) the fourth row sub-headings should read “% ↓ C interval mean vs TC, LDL and Lp(a) off treatment” not “% ↓ C interval mean vs baseline TC, LDL and Lp(a).”
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- Acute effect of a single session of lipoprotein apheresis on central haemodynamics in patients with familial hypercholesterolaemiaAtherosclerosisVol. 325
- PreviewWe read with interest the paper by Pottle et al. demonstrating a 62.5% reduction in major adverse cardiovascular events following introduction of lipoprotein apheresis (LA) [1]. Previous work has shown that LA results in improvements in coronary and peripheral vasomotor function, which may, in part account for the associated improvements in clinical outcomes, alongside the reduction in atherogenic ApoB-containing particles [2,3]. However, pulse wave velocity (PWV) and augmentation index (AIx) appear unchanged post-LA [4,5] but its influence on other cardiovascular physiological biomarkers is less well known.
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