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Lipoprotein apheresis is an optimal therapeutic option to reduce increased Lp(a) levels
AbstractBackgroundLipoprotein(a) (Lp(a)) is a  genetic risk factor for cardiovascular disease (CVD) and is associated with the induction and sustaining of atherosclerotic cardiovascular diseases (ASCVD). Since 2008 Lp(a) along with progressive CVD has been approved as an indication for regular lipoprotein apheresis (LA) in Germany. The German Lipoprotein Apheresis Registry (GLAR) has been initiated to provide statistical evidence for the assessment of extracorporeal procedures to treat dyslipidemia for both LDL-cholesterol (LDL-C) and Lp(a). The GLAR now allows prospective investigations over a 5-year period about annual...
Source: Clinical Research in Cardiology Supplements - March 4, 2019 Category: Cardiology Source Type: research

Lipoprotein(a) —an interdisciplinary challenge
AbstractLipoprotein(a) (Lp(a)) is an internationally recognized atherogenic risk factor which is inherited and not changed by nutrition or physical activity. At present, only proprotein convertase subtilisin/kexin type  9 (PCSK9) inhibitors may modestly decrease its concentration (but not in all patients)—leading to a certain decrease in cardiovascular events (CVE) in controlled studies. However, at present an elevation of Lp(a) is not a generally accepted indication for their use. More effective is lipoprote in apheresis (LA) therapy with respect to both lowering Lp(a) levels and reduction of CVE. In the future, an a...
Source: Clinical Research in Cardiology Supplements - March 4, 2019 Category: Cardiology Source Type: research

Lipoprotein(a) and mortality —a high risk relationship
AbstractLipoprotein(a) (Lp(a)) is an independent cardiovascular risk factor playing a  causal role for atherosclerotic cardiovascular disease (ASCVD). Early or progressive ASCVD or a familial predisposition are key findings which can be associated with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP). The German guideline for the indication of lipoprotein apheresis in patients with Lp(a)-HLP has proved to be of value to identify patients at highest risk, using the composite of a Lp(a) threshold>60  mg/dl (>120  nmol/l) and clinical ASCVD progression despite effective LDL-C lowering therapy. In particular for such patien...
Source: Clinical Research in Cardiology Supplements - March 4, 2019 Category: Cardiology Source Type: research

Erratum to: The German Lipoprotein Apheresis Registry (GLAR) – almost 5 years on
(Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - July 17, 2017 Category: Cardiology Source Type: research

Primary and secondary prevention of cardiovascular disease in patients with hyperlipoproteinemia  (a)
AbstractGeneral lipoprotein (Lp)  (a) screening can help to identify patients at high risk for cardiovascular disease. Non-invasive methods allow early detection of clinically asymptomatic incipient atherosclerotic disease. Medical treatment options are still unsatisfactory. Lp(a) apheresis is an established treatment in Germany f or secondary prevention of progressive cardiovascular disease. Statin-based lowering of LDL cholesterol and thrombocyte aggregation inhibitors still represent the basis of medical treatment. Target levels for LDL-cholesterol should be modified in patients with hyperlipoproteinemia (a). (Source:...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Lipoprotein  (a) and coronary heart disease – is there an efficient secondary prevention?
AbstractLipoprotein  (a) (Lp (a)) is one risk factor for the development of cardiovascular diseases. Several studies have shown that Lp (a) hyperlipoproteinaemia has a particular influence on the development of coronary heart disease (CHD). A retrospective single-centre observation study was performed to evaluate the effectiveness of lipid apheresis on the basis of consecutively performed percutaneous coronary interventions (PCI) in patients with high Lp (a) values and angiographically documented CHD.In 23  pts (male 18, age 60.04 ± 0.58 years) with angiographically documented CHD (first manifestation 48.00 ±...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

The German Lipoprotein Apheresis Registry (GLAR) – almost 5 years on
ConclusionsThe data generated by the GLAR shows that LA lowers the incidence rate of cardiovascular events in patients with high LDL-C and/or high Lp  (a) levels, progressive CVD, and maximally tolerated lipid lowering medication. In addition, LA treatments were found to be safe with a low rate of side effects. (Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Hyperlipoproteinaemia(a) – apheresis and emerging therapies
AbstractA  high level of lipoprotein(a) (Lp(a)) is recognized as an independent and additional cardiovascular risk factor contributing to the risk of early onset and progressive course of cardiovascular disease (CVD). All lipid lowering medications in use mainly lower low density lipoprotein-cholesterol (LDL -c) with no or limited effect on levels of Lp(a). Niacin, the only component lowering Lp(a), is firstly often poorly tolerated and secondly not available anymore in many countries. A level of<50  mg/dl was recommended recently as the cut off level for clinical use and decision making. Since lipoprotein apheresis...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Incidence of elevated lipoprotein  (a) levels in a large cohort of patients with cardiovascular disease
ConclusionIn patients admitted to a  cardiovascular center the proportion of LPA>30  mg/dl is comparable to the general population but mean levels over all are twice as high and the proportion of patients with LPA levels of>98  mg/dl is extremely higher. (Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Prevention of cardiovascular complications in patients with Lp(a)-hyperlipoproteinemia and progressive cardiovascular disease by long-term lipoprotein apheresis according to German national guidelines
AbstractLipoprotein(a) (Lp(a)) is an independent cardiovascular risk factor playing a  causal role for atherosclerotic cardiovascular disease (CVD). Lipoprotein apheresis (LA) is a safe well-tolerated outpatient treatment to lower LDL-C and Lp(a) by 60–70%, and is the ultimate escalating therapeutic option in patients with hyperlipoproteinemias (HLP) involving LDL particles. Majo r therapeutic effect of LA is preventing cardiovascular events. Lp(a)-HLP associated with progressive CVD has been approved as indication for regular LA in Germany since 2008. The Pro(a)LiFe-study investigated with a prospective multicenter d...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Lipoprotein(a) and its role in inflammation, atherosclerosis and malignancies
AbstractLipoprotein  (a) (Lp(a)) is a modified low-density lipoprotein (LDL) particle with an additional specific apolipoprotein (a), covalently attached to apolipoprotein B‑100 of LDL by a single thioester bond. Increased plasma Lp(a) level is a genetically determined, independent, causal risk factor for cardio vascular disease.The precise quantification of Lp(a) in plasma is still hampered by mass-sensitive assays, large particle variation, poor standardization and lack of assay comparability.The physiological functions of Lp(a) include wound healing, promoting tissue repair and vascular remodeling. Similarly to o...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Lipoprotein(a) in nephrological patients
AbstractIn contrast to existing EAS/ESC guidelines on the management of lipid disorders, current recommendations from nephrological societies are very conservative and restrictive with respect to any escalation of lipid lowering/statin therapy. Furthermore, lipoprotein(a) (Lp(a)) – an established cardiovascular risk factor – has not even been mentioned. While a number of retrospective and prospective studies suggested that Lp(a) has relevant predictive value and might have – at least in stage-3 chronic kidney disease (CKD) – the same negative effects if draged along in non-CKD patients, there is no guidance on dia...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research

Lipoprotein(a)-hyperlipoproteinemia as cause of chronic spinal cord ischemia resulting in progressive myelopathy – successful treatment with lipoprotein apheresis
AbstractHigh concentrations of lipoprotein(a) (Lp(a)) represent an important independent and causal risk factor associated with adverse outcome in atherosclerotic cardiovascular disease (CVD). Effective Lp(a) lowering drug treatment is not available. Lipoprotein apheresis (LA) has been proven to prevent cardiovascular events in patients with Lp(a)-hyperlipoproteinemia (Lp(a)-HLP) and progressive CVD. Here we present the course of a  male patient with established peripheral arterial occlusive disease (PAOD) at the early age of 41 and coronary artery disease (CAD), who during follow-up developed over 2 years a progressive...
Source: Clinical Research in Cardiology Supplements - March 1, 2017 Category: Cardiology Source Type: research