COVID-19 and Lipid Disorders

Julius, Ulrich; Schatz, Ulrike; Tselmin, Sergey; Morawietz, Henning

doi:10.1055/a-1860-2610

Cited by 9 publications

(11 citation statements)

References 50 publications

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“…LA und COVID-19 : In der Literatur wird eine vermehrte Gefährdung einer Infektion mit dem Coronavirus bei Patienten mit HCH beschrieben 21 . Das Risiko für diese Infektion war bei Apherese-Patienten allerdings deutlich geringer als bei Hämodialyse-Patienten.…”

Section: Gefäßveränderungen Beim Vergleich Mit Einer Schein-apherese ...unclassified

State of the Art: Lipoproteinapherese

Schatz¹,

Schettler²,

Julius³

2023

Dtsch Med Wochenschr

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Lipoprotein apheresis (LA) is usually a last resort in cardiovascular high-risk patients in the context of secondary prevention after lifestyle measures and maximal pharmacotherapy have failed to prevent the occurrence of new atherosclerotic cardiovascular events (ASCVDE) or to achieve the internationally accepted target values for LDL cholesterol (LDL-C). Patients with homozygous familial hypercholesterolemia (hoFH), in whom myocardial infarctions can occur even in children < 10 years of age without adequate therapy, often owe their survival to LA (used here in primary prevention). Severe hypercholesterolemia (HCH) can often be well controlled with modern potent lipid-lowering agents, including PCSK9 approaches, so that the need for LA has decreased here over the years. In contrast, the number of patients in whom elevation of lipoprotein(a) (Lp(a)) is relevant to atherogenesis is increasing in applications to the apheresis committees of the associations of panel physicians (KV). For this indication, LA is currently the only therapeutic procedure approved by the Federal Joint Committee (G-BA). LA significantly reduces the new occurrence of ASCVDE (comparison with the situation before the start of LA), especially in Lp(a) patients. There are convincing observational studies and a German LA Registry with now 10-year data, but there is no randomized controlled trial. This had been requested by the G-BA in 2008, and a corresponding concept was designed but not accepted by the ethics committee. In addition to the highly effective reduction of atherogenic lipoproteins, many discussed pleiotropic effects of LA itself, the medical rounds and motivating discussions also with the nursing staff, which take place within the weekly LA, certainly contribute to the success of the therapy (steady adjustment of all cardiovascular risk factors, lifestyle measures including smoking cessation, adherence of medication intake). This review article summarizes and discusses the study situation, clinical practical experience as well as the future of LA against the background of the currently rapid development of new pharmacotherapies.

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Section: Gefäßveränderungen Beim Vergleich Mit Einer Schein-apherese ...unclassified

State of the Art: Lipoproteinapherese

Schatz¹,

Schettler²,

Julius³

2023

Dtsch Med Wochenschr

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“…Higher levels of LDL-C and HDL-C were negatively linked with CRP. Although a fairly regular test, triglyceride levels were not consistently found to be significantly associated with an increased risk [ 91 , 92 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Musat,

Sorop,

Sorop

et al. 2023

Life

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COVID-19 has significantly impacted the whole world, and Romania was no exception. Biomarkers play a crucial role in understanding and managing the disease. However, research regarding laboratory analyses for patients with COVID-19 is fairly limited. For detection, PCR testing is still considered the golden standard, while antibodies are still useful for monitoring both patients and their vaccination status. In our country, biomarkers such as CRP, LDH, transaminases, cardiac, and iron markers have been used to assess the status of patients and even predict illness outcome. CRP, IL-6, LDH, FER, fibrinogen, creatinine, and vitamin D levels have been associated with increased severity, risk of ICU admission, and death. Cardiac markers and D-dimers are also good predictors, but their role seems more important in patients with complications. HDL cholesterol and BUN levels were also suggested as potential biomarkers. Hematological issues in SARS-CoV-2 infections include neutrophilia, lymphopenia and their ratio, while PCT, which is a marker of bacterial infections, is better to be used in patients with co- or supra-infections. The current research is a narrative review that focuses on the laboratory results of Romanian COVID-19 patients. The goal of this article is to provide an update on the research on biomarkers and other laboratory tests conducted inside the borders of Romania and identify gaps in this regard. Secondly, options for further research are discussed and encouraged.

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“…Thus, aprotinin can promote anti-inflammatory responses in vessels [45,46]. Finally, COVID-19 patients are at increased risk to develop cardiovascular diseases [47]. Recently, also inhaled aprotinin was shown to be safe and could improved standard treatment and clinical outcomes of hospitalized patients with COVID-19 [48].…”

Section: Discussionmentioning

confidence: 99%

Aprotinin does not Impair Vascular Function in Patients Undergoing Coronary Artery Bypass Graft Surgery

et al. 2023

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Bleeding is a major complication in coronary artery bypass graft surgery. Antifibrinolytic agents like serine protease inhibitor aprotinin can decrease postoperative bleeding and complications of cardiac surgery. However, the effects of aprotinin on vascular function are not completely elucidated. We compared the ex vivo vascular function of left internal mammary arteries from patients undergoing coronary artery bypass graft surgery with and without intraoperative application of aprotinin using a Mulvany Myograph. Human internal mammary arteries were treated with aprotinin ex vivo and tested for changes in vascular function. We analyzed the impact of aprotinin on vascular function in rat aortic rings. Finally, impact of aprotinin on expression and activity of endothelial nitric oxide synthase was tested in human endothelial cells. Intraoperative application of aprotinin did not impair ex vivo vascular function of internal mammary arteries of patients undergoing coronary artery bypass graft surgery. Endothelium-dependent and -independent relaxations were not different in patients with or without aprotinin after nitric oxide synthase blockade. A maximum vasorelaxation of 94.5%±11.4vs. 96.1%±5.5% indicated a similar vascular smooth muscle function in both patient groups (n=13 each). Long-term application of aprotinin under physiological condition preserved vascular function of the rat aorta. In vitro application of increasing concentrations of aprotinin on human endothelial cells resulted in a similar expression and activity of endothelial nitric oxide synthase. In conclusion, intraoperative and ex vivo application of aprotinin does not impair the endothelial function in human internal mammary arteries and experimental models.

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COVID-19 and Lipid Disorders

Cited by 9 publications

References 50 publications

State of the Art: Lipoproteinapherese

State of the Art: Lipoproteinapherese

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Aprotinin does not Impair Vascular Function in Patients Undergoing Coronary Artery Bypass Graft Surgery

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