Treatment of symptomatic hyperLp(a)lipidemia with LDL-apheresis vs. usual care

Background/aims: To assess LDL-apheresis efficacy to lower Lp(a) and to compare the effects of Usual Medical Care (UMC) a 12-months study was carried out. The incidence of new coronary artery disease (CAD) events/need of revascularization, was also monitored. Methods: Twenty-one patients with hyperLp(a)lipidemia and angiographically documented CAD were randomly assigned to LDL-apheresis every week, or the UMC. Results: LDL-apheresis group, averaged an Lp(a) reduction of 57.8 ± 9.5% vs. basal values (P < 0.001). In the UMC group Lp(a) increased in 1 year to 14.7 ± 36.5% (P = 0.66). Stepwise multivariate regression analysis for predictors of Lp(a) including: type of treatment, smoking, hypertension, age, age at first cardiovascular event, initial Lp(a), LDL, and BMI values, was performed. Only the type of treatment was co-related (P < 0.001): Lp(a) variation (beta) = 0.863. The model has R2 adjusted relative risk of 0.725. Conclusion: LDL-apheresis could be the first line treatment of isolated hyperLp(a)lipidemia when CAD is established. New CAD events/cardiac interventions were not observed.