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Indications for apheresis as an ultima ratio treatment of refractory hyperlipidemias
AbstractLipid apheresis is at present well established in routine treatment of diverse hyperlipoproteinemias refractory to conventional dietary and medical regimens, especially in countries with high medical and socioeconomic standards. Severe familial hypercholesterolemia with atherosclerotic vessel disease involving the coronary arteries is the most frequent indication for lipid apheresis as well as homozygous familial hypercholesterolemia before the development of cardiovascular complications.In hyperlipoproteinemia (a) with progressive vessel disease, lipid apheresis is regularly accepted in Germany. The indication of ...
Source: Clinical Research in Cardiology Supplements - April 1, 2015 Category: Cardiology Source Type: research

Lipoprotein apheresis results in plaque stabilization and prevention of cardiovascular events: comments on the prospective Pro(a)LiFe study
AbstractElevated lipoprotein(a) (Lp(a)) has emerged as an important independent cardiovascular risk factor, and causal association has been accepted with adverse outcome in atherosclerotic disease. Lipoprotein apheresis (LA) can lower low-density lipoprotein (LDL)-cholesterol and Lp(a) by 60 –70 % and is the final escalating therapeutic option in patients with hyperlipoproteinemias (HLP) involving LDL or Lp(a) particles. Major therapeutic effect of LA is preventing cardiovascular events. Stabilizing plaque morphology might be an important underlying mechanism of action. In Germany, s ince 2008, a reimbursement guideline...
Source: Clinical Research in Cardiology Supplements - April 1, 2015 Category: Cardiology Source Type: research

Lipoprotein(a) – Einfluss auf die kardiovaskuläre Manifestation
ZusammenfassungDer klinischen Relevanz von Lipoprotein(a) [Lp(a)] als kardiovaskul ärer Risikofaktor wird aktuell nur bedingt die notwendige Bedeutung beigemessen. Es gilt zu klären, welchen Einfluss erhöhte Lp(a)-Werte auf die Entstehung und den Schweregrad einer koronaren Herzkrankheit (KHK) hat.In einer retrospektiven Analyse erfolgte die Auswertung von 31.274 Patienten, die erstmals station är aufgenommen wurden. Es wurden Patienten verglichen mit isoliert erhöhtem Lp(a) (>  110 mg/dl) und normwertigen Lp(a) (<  30 mg/dl), mit steigenden Lp(a)-Konzentrationen (30–60 mg/dl, 61–90 mg/dl, 91–110 mg...
Source: Clinical Research in Cardiology Supplements - April 1, 2015 Category: Cardiology Source Type: research

Editorial
(Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - April 1, 2015 Category: Cardiology Source Type: research

Extrakardiale Manifestation der Lipoprotein(a)-Erh öhung – Gehäuftes Auftreten von peripherer arterieller Verschlusskrankheit und Stenosen der Arteria carotis
< h3 class= " a-plus-plus " > Zusammenfassung < /h3 > < span class= " a-plus-plus abstract-section id-a-sec1 " > < h3 class= " a-plus-plus " > Einleitung < /h3 > < p class= " a-plus-plus " > Ein Zusammenhang zwischen erh öhten Lp(a)-Werten und der Inzidenz der KHK ist eindeutig belegt. Die Bedeutung einer Lp(a)-Erhöhung für die Entstehung einer Arteriosklerose mit extrakardialer Manifestation ist bisher nur wenig untersucht. Inwieweit ein erhöhter Lp(a)-Wert als eigenständiger Risikofaktor für das Auftreten ei ner peripheren arteriellen Verschlusskrankheit (pAVK) und einer Stenose der Arteria carotis interna (ACIS) g...
Source: Clinical Research in Cardiology Supplements - March 31, 2015 Category: Cardiology Source Type: research

Lipoprotein(a) —clinical aspects and future challenges
< h3 class= " a-plus-plus " > Abstract < /h3 > < p class= " a-plus-plus " > Lipoprotein(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 demons...
Source: Clinical Research in Cardiology Supplements - March 31, 2015 Category: Cardiology Source Type: research

Lipoprotein(a)—clinical aspects and future challenges
Abstract Lipoprotein(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, sev...
Source: Clinical Research in Cardiology Supplements - March 3, 2015 Category: Cardiology Source Type: research

Lipoprotein(a) hyperlipidemia as cardiovascular risk factor: pathophysiological aspects
Abstract Lipoprotein (a) [Lp(a)] is a modified LDL particle with an additional apolipoprotein [apo(a)] protein covalently attached by a thioester bond. Multiple isoforms of apo(a) exist that are genetically determined by differences in the number of Kringle-IV type-2 repeats encoded by the LPA gene. Elevated plasma Lp(a) is an independent risk factor for cardiovascular disease. The phenotypic diversity of familial Lp(a) hyperlipidemia [Lp(a)-HLP] and familial hypercholesterolemia [FH], as defined risks with genetic background, and their frequent co-incidence with additional cardiovascula...
Source: Clinical Research in Cardiology Supplements - February 24, 2015 Category: Cardiology Source Type: research

Editorial
(Source: Clinical Research in Cardiology Supplements)
Source: Clinical Research in Cardiology Supplements - February 19, 2015 Category: Cardiology Source Type: research

Indications for apheresis as an ultima ratio treatment of refractory hyperlipidemias
Abstract Lipid apheresis is at present well established in routine treatment of diverse hyperlipoproteinemias refractory to conventional dietary and medical regimens, especially in countries with high medical and socioeconomic standards. Severe familial hypercholesterolemia with atherosclerotic vessel disease involving the coronary arteries is the most frequent indication for lipid apheresis as well as homozygous familial hypercholesterolemia before the development of cardiovascular complications. In hyperlipoproteinemia (a) with progressive vessel disease, lipid apheresis is regularly a...
Source: Clinical Research in Cardiology Supplements - February 17, 2015 Category: Cardiology Source Type: research

Clinical benefit of long-term lipoprotein apheresis in patients with severe hypercholesterolemia or Lp(a)-hyperlipoproteinemia with progressive cardiovascular disease
Abstract Low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) are established causal risk factors for cardiovascular disease (CVD). Efficacy, safety, and tolerability of lipoprotein apheresis (LA) were investigated in 118 patients with CVD covering a period with 36,745 LA treatments in a retrospective, monocentric study. Indications for LA were severe hypercholesterolemia (n = 83) or isolated Lp(a) hyperlipoproteinemia (Lp(a)-HLP) (n = 35). In patients with hypercholesterolemia, initial pre-LA LDL-C was 176.4 ± 67.0 mg/dL. In patients with isolated Lp(a)-HLP, initial pre-LA Lp(a)...
Source: Clinical Research in Cardiology Supplements - February 12, 2015 Category: Cardiology Source Type: research

Extrakardiale Manifestation der Lipoprotein(a)-Erhöhung – Gehäuftes Auftreten von peripherer arterieller Verschlusskrankheit und Stenosen der Arteria carotis
Zusammenfassung Einleitung Ein Zusammenhang zwischen erhöhten Lp(a)-Werten und der Inzidenz der KHK ist eindeutig belegt. Die Bedeutung einer Lp(a)-Erhöhung für die Entstehung einer Arteriosklerose mit extrakardialer Manifestation ist bisher nur wenig untersucht. Inwieweit ein erhöhter Lp(a)-Wert als eigenständiger Risikofaktor für das Auftreten einer peripheren arteriellen Verschlusskrankheit (pAVK) und einer Stenose der Arteria carotis interna (ACIS) gesehen werden kann, war Ziel der vorliegenden Untersuchung. ...
Source: Clinical Research in Cardiology Supplements - February 10, 2015 Category: Cardiology Source Type: research

Lipoprotein(a) – Einfluss auf die kardiovaskuläre Manifestation
Zusammenfassung Der klinischen Relevanz von Lipoprotein(a) [Lp(a)] als kardiovaskulärer Risikofaktor wird aktuell nur bedingt die notwendige Bedeutung beigemessen. Es gilt zu klären, welchen Einfluss erhöhte Lp(a)-Werte auf die Entstehung und den Schweregrad einer koronaren Herzkrankheit (KHK) hat. In einer retrospektiven Analyse erfolgte die Auswertung von 31.274 Patienten, die erstmals stationär aufgenommen wurden. Es wurden Patienten verglichen mit isoliert erhöhtem Lp(a) (> 110 mg/dl) und normwertigen Lp(a) (< 30 mg/dl), mit steigenden Lp(a)-Konzentrationen (30–60 m...
Source: Clinical Research in Cardiology Supplements - February 10, 2015 Category: Cardiology Source Type: research

Impact of the German Lipoprotein Apheresis Registry (DLAR) on therapeutic options to reduce increased Lp(a) levels
Conclusions The 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 extracta...
Source: Clinical Research in Cardiology Supplements - February 5, 2015 Category: Cardiology Source Type: research

Lipoprotein apheresis results in plaque stabilization and prevention of cardiovascular events: comments on the prospective Pro(a)LiFe study
Abstract Elevated lipoprotein(a) (Lp(a)) has emerged as an important independent cardiovascular risk factor, and causal association has been accepted with adverse outcome in atherosclerotic disease. Lipoprotein apheresis (LA) can lower low-density lipoprotein (LDL)-cholesterol and Lp(a) by 60–70 % and is the final escalating therapeutic option in patients with hyperlipoproteinemias (HLP) involving LDL or Lp(a) particles. Major therapeutic effect of LA is preventing cardiovascular events. Stabilizing plaque morphology might be an important underlying mechanism of action. In Germany, since 2008, a reimbu...
Source: Clinical Research in Cardiology Supplements - February 2, 2015 Category: Cardiology Source Type: research