Long-term efficacy of low-density lipoprotein apheresis on coronary heart disease in familial hypercholesterolemia

Mabuchi, Hiroshi; Koizumi, Junji; Shimizu, Masami; Kajinami, Kouji; Miyamoto, Susumu; Ueda, Kousei; Takegoshi, Tadayoshi

doi:10.1016/s0002-9149(98)00692-4

Cited by 271 publications

(147 citation statements)

References 18 publications

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“…In the so-called Hokuriku study, the largest controlled clinical trial on LDL apheresis, the percentage of patients without any coronary event (cardiac death, MI, CABG, and PTCA) within 6 years was 90% in the apheresis group and 64% in the medication group. 22) In the present study, the percentage of event-free survival for 6 years was 66.7%, which was relatively low and near the control group level in the Hokuriku study. However, the comparison of minor coronary events with other facilities may be difficult, because of uncontrolled indications of PTCA and interpretations of angiographic data.…”

Section: Discussioncontrasting

confidence: 46%

Ten-year Follow-up of Familial Hypercholesterolemia Patients After Intensive Cholesterol-lowering Therapy

Masaki

Tatami²,

Kumamoto³

et al. 2005

Int. Heart J.

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SUMMARYTo prevent coronary artery disease, it is necessary for patients with familial hypercholesterolemia (FH) to maintain a low cholesterol level. Recently a combination therapy of low-density lipoprotein (LDL) apheresis and statins has been used for FH patients, but their long-term prognosis over 10 years is unknown.In this single center prospective report, 18 FH patients with severe coronary stenosis received LDL apheresis every 2 or 4 weeks and statin therapy for 9.8 ± 3.0 years. Probucol was given to 17 of the 18 patients. We observed their clinical events as well as coronary stenosis findings and ejection fractions for 10.7 ± 2.6 years.Total and LDL cholesterol levels before therapy were 345 ± 46 and 277 ± 48 mg/ dL, respectively. Immediately following LDL-apheresis, these levels decreased to 104 ± 7.5 and 66 ± 16 mg/dL, respectively. There were no cardiac deaths and 4 patients were free from any coronary events. There was one noncardiac death. Nonfatal myocardial infarction occurred in 2 patients and coronary bypass surgery was required in one patient. Twelve patients received additional coronary angioplasty. There was little change in coronary stenosis and ejection fraction following 10 years of the combination therapy. Univariate Cox regression analysis revealed that the calculated mean LDL cholesterol level was the predictive value of treatment efficacy (mean LDL cholesterol < 140 mg/dL, hazard ratio 0.23, P = 0.028). The combination therapy of LDL-apheresis and antilipid drugs delayed the progression of coronary atherosclerosis and prevented a major cardiac event, although complete inhibition was limited to a small group. Additional coronary angioplasty is likely to be required for a favorable clinical outcome in FH patients. (Int Heart J 2005; 46: 833-843)

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Section: Discussioncontrasting

confidence: 46%

Ten-year Follow-up of Familial Hypercholesterolemia Patients After Intensive Cholesterol-lowering Therapy

Masaki

Tatami²,

Kumamoto³

et al. 2005

Int. Heart J.

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“…LDL-cholesterol (LDL-C) accounts for approximately two thirds of the serum cholesterol pool in a normal subject and is believed to play an important role in arteriosclerosis. Therefore, monitoring of LDL-C in the serum via diet also provides a basis for the prevention of possible threat of hyperlipidemia (14). LDL-C and HDL-cholesterol (HDL-C) respectively, are positive and negative cardiovascular (CV) risk factors associated with deaths by myocardial infarction (15,16).…”

Section: Resultsmentioning

confidence: 99%

Hypocholesterolemic and hepatoprotective effects of flaxseed chutney: Evidence from animal studies

Shakir

Madhusudhan

2007

Indian J Clin Biochem

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“…Some studies have reported that LDL apheresis therapy was safe in children without influencing development/growth, and that this therapy led to the reduction/disappearance of skin xanthoma, inhibiting exacerbation of aortic valve stenosis/supravalvular stenosis, which are characteristic of homozygous FH, and coronary lesions, or resulting in improvement [73][74][75][76][77][78][79][80] . Irondeficiency anemia is the most frequent side effect.…”

Section: Effects Of Ldl Apheresismentioning

confidence: 99%

Guidelines for the Management of Familial Hypercholesterolemia

Harada‐Shiba

Arai

Oikawa

et al. 2012

JAT

167

164

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Familial hypercholesterolemia (FH) is a highly prevalent autosomal dominant hereditary disease, generally characterized by three major signs, hyper-low-density-lipoprotein (LDL) cholesterolemia, tendon/skin xanthomas and premature coronary artery disease (CAD). Because the risk of CAD is very high in these patients, they should be identified at an early stage of their lives and started on intensive treatment to control LDL-cholesterol. We here introduce a new guideline for the management of FH patients in Japan intending to achieve better control to prevent CAD. Diagnostic criteria for heterozygous FH are 2 or more of 1) LDL-cholesterol ≥ 180 mg/dL, 2) tendon/skin xanthoma(s), and 3) family history of FH or premature CAD within second degree relatives, for adults; and to have both 1) LDL-cholesterol ≥ 140 mg/dL and 2) family history of FH or premature CAD within second degree relatives, for children. For the treatment of adult heterozygous FH, intensive lipid control with statins and other drugs is necessary. Other risks of CAD, such as smoking, diabetes mellitus, hypertension etc., should also be controlled strictly. Atherosclerosis in coronary, carotid, or peripheral arteries, the aorta and aortic valve should be screened periodically. FH in children, pregnant women, and women who wish to bear a child should be referred to specialists. For homozygotes and severe heterozygotes resistant to drug therapies, LDL apheresis should be performed. The treatment cost of homozygous FH is authorized to be covered under the program of Research on Measures against Intractable Diseases by the Japanese Ministry of Health, Labour, and Welfare.

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Long-term efficacy of low-density lipoprotein apheresis on coronary heart disease in familial hypercholesterolemia

Cited by 271 publications

References 18 publications

Ten-year Follow-up of Familial Hypercholesterolemia Patients After Intensive Cholesterol-lowering Therapy

Ten-year Follow-up of Familial Hypercholesterolemia Patients After Intensive Cholesterol-lowering Therapy

Hypocholesterolemic and hepatoprotective effects of flaxseed chutney: Evidence from animal studies

Guidelines for the Management of Familial Hypercholesterolemia

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