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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 - February 22, 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 - February 21, 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 - February 9, 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 - February 8, 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 - February 8, 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 - February 7, 2017 Category: Cardiology Source Type: research

PCSK9 targets important for lipid metabolism
AbstractIschemic heart disease is the main cause of death worldwide and it is accelerated by increased low-density lipoprotein (LDL) cholesterol (LDL-C) and/or lipoprotein (a) (Lp(a)) concentrations. Proprotein convertase subtilisin/kexin type  9 (PCSK9) alters both LDL-C and in part Lp(a) concentrations through its ability to induce degradation of the LDL receptor (LDLR). PCSK9, however, has additional targets which are potentially involved in lipid metabolism regulation such as the very low density lipoprotein receptor (VLDL),CD36 (cluster of differentiation  36) and the epithelial cholesterol transporter (NPC1L1) and ...
Source: Clinical Research in Cardiology Supplements - February 6, 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 - February 2, 2017 Category: Cardiology Source Type: research

Rehabilitationsstandards f ür die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)
AbstractThe increasing use of ventricular assist devices (VADs) in terminal heart failure patients provides new challenges to cardiac rehabilitation physicians. Structured cardiac rehabilitation strategies are still poorly implemented for this special patient group. Clear guidance and more evidence for optimal modalities are needed. Thereby, attention has to be paid to specific aspects, such as psychological and social support and education (e.g., device management, INR self-management, drive-line care, and medication).In Germany, the post-implant treatment and rehabilitation of VAD Patients working group was founded in 20...
Source: Clinical Research in Cardiology Supplements - March 1, 2016 Category: Cardiology Source Type: research

Geleitwort zu „Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation für Patienten mit einem Herzunterstützungssystem (VAD Ventricular Assist Device)“
(Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - March 1, 2016 Category: Cardiology Source Type: research

Rehabilitationsstandards f ür die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)
< h3 class= " a-plus-plus " > Abstract < /h3 > < p class= " a-plus-plus " > The increasing use of ventricular assist devices (VADs) in terminal heart failure patients provides new challenges to cardiac rehabilitation physicians. Structured cardiac rehabilitation strategies are still poorly implemented for this special patient group. Clear guidance and more evidence for optimal modalities are needed. Thereby, attention has to be paid to specific aspects, such as psychological and social support and education (e.g., device management, INR self-management, drive-line care, and medication). < /p > < p class= " a-plus-plus " > ...
Source: Clinical Research in Cardiology Supplements - February 29, 2016 Category: Cardiology Source Type: research

Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)
Abstract The increasing use of ventricular assist devices (VADs) in terminal heart failure patients provides new challenges to cardiac rehabilitation physicians. Structured cardiac rehabilitation strategies are still poorly implemented for this special patient group. Clear guidance and more evidence for optimal modalities are needed. Thereby, attention has to be paid to specific aspects, such as psychological and social support and education (e.g., device management, INR self-management, drive-line care, and medication). In Germany, the post-implant treatment and rehabilitation of VAD Pa...
Source: Clinical Research in Cardiology Supplements - February 16, 2016 Category: Cardiology Source Type: research

Geleitwort zu „Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation für Patienten mit einem Herzunterstützungssystem (VAD Ventricular Assist Device)“
(Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - February 16, 2016 Category: Cardiology Source Type: research

Impact of the German Lipoprotein Apheresis Registry (DLAR) on therapeutic options to reduce increased Lp(a) levels
ConclusionsThe available numbers suggest in parts very good response by the participating centres to the DLAR. Unfortunately, there are also centres that have not documented any patients so far or LA treatments at all. The benchmark values for reduction rates in lipoprotein concentration required by the directives of the German Federal Joint Committee (G-BA) have all been met. The decrease in MACE and MANCE rates currently observed is very promising. However, the comparably short runtime of the registry does not allow for high confidence in the current results. Certainly, reliable data will be extractable in the coming yea...
Source: Clinical Research in Cardiology Supplements - April 1, 2015 Category: Cardiology Source Type: research

Lipoprotein(a) —clinical aspects and future challenges
AbstractLipoprotein(a) (Lp(a)) was first described by K. Berg and is known for more than 50 years. It is an interesting particle and combines the atherogenic properties of low-density lipoprotein (LDL)-cholesterol as well as the thrombogenic properties of plasminogen inactivation. However, due to technical problems and publication of negative trials the potential role of Lp(a) in atherosclerosis was severely underestimated. In recent years our understanding of the function and importance of Lp(a) improved. Interventional trials with niacin failed to demonstrate any benefit of lowering Lp(a); however, several studies confir...
Source: Clinical Research in Cardiology Supplements - April 1, 2015 Category: Cardiology Source Type: research