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Low-Density Lipoprotein Apheresis in the Treatment of Atherosclerosis and Other
Potential Uses
Current Atherosclerosis Reports
2001;3:156-162.
Patrick M. Moriarty, MD, Cheryl A. Gibson, PhD
This review addresses the potential benefit of using LDL-apheresis to treat not
only atherosclerosis but also diseases not normally targeted by the original design
of the system.
Atherosclerosis: LDL-apheresis has been shown to:
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Reduce cardiovascular events. |
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Improve vascular wall structure and physiology. |
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LDL-apheresis treatment has been shown to lead to a significant regression in coronary
stenosis and slow the progression of carotid intima-media thickness. |
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The LDL-Apheresis Atherosclerosis Regression Study (LAARS) demonstrated the ability
of a combination of simvastatin and LDL-apheresis to significantly decrease the
maximum level of ST depression by 0.007 millivolt (mV) and to increase time to 0.1
mV ST-segment depression by 39% when compared with medication alone. |
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Reduction of plasma viscosity by LDL-apheresis significantly improved middle cerebral
artery vasoreactivity. |
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Reduce LDL mass, improve LDL-density profiles, and potentially increase lipoprotein
lipase activity. |
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Reduce the levels of serum inflammatory markers. |
Sudden hearing loss: Sudden hearing loss has been linked with various
vascular alterations, as well as with the presence of hypercholesterolemia and hyperfibrinogenemia.
• LDL-apheresis treatment to remove plasma fibrinogen and LDL-C results in
improvement of auditory thresholds in patients with sudden hearing loss.
Sepsis:
• LDL-apheresis, especially heparin-induced method, has been shown to effectively
remove endotoxins and proinflammatory cytokines from the blood.
Diabetic nephropathy: Evidence suggests that hypercholesterolemia is
an important risk factor for the progressive impairment of kidney function in patients
with diabetes.
• LDL-apheresis has been shown to slow the progression of diabetic nephropathy.
Transplant coronary artery disease: Hyperlipidemia is common among
heart transplant recipients and may contribute to the development of coronary vasculopathy.
• Increases in coronary artery mean luminal diameter were observed following
LDL-apheresis treatment in combination with diet therapy and treatment with pravastatin.
Cognitive function: The improved cardiovascular and cerebrovascular
status seen with lipid-lowering interventions suggests a possible benefit of such
treatments on the cognitive and emotional functions of patients. LDL-apheresis treatment
via the heparin-induced method of patients with acute embolic stroke or multi-infarct
dementia resulted in improved cognitive test scores.
Click for full abstract.
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