Page 85 - Read Online

Yaroustovsky et al. Vessel Plus 2019;3:9 Vessel Plus
DOI: 10.20517/2574-1209.2019.02

Original Article Open Access

The use of lipoprotein apheresis for the treatment
of high-risk patients with elevated lipoprotein(a) and
hypercholesterolemia

Michael Yaroustovsky, Marina Abramyan, Ekaterina Rogalskaya, Ekaterina Komardina

Federal State Budget Institution «A.N.Bakulev National Medical Research Centre for Cardiovascular Surgery» of the Ministry of
Healthcare of the Russian Federation (Bakulev NMRCCS), Moscow 121552, Russia.

Correspondence to: Prof. Michael Yaroustovsky, Burakovsky Institute for cardiac surgery, Department of Detoxication and
Endoscopy Bakulev National Medical Research Centre for Cardiovascular Surgery, Rublevskoe highway 135, Moscow 121552,
Russia. E-mail: mbyar@yandex.ru

How to cite this article: Yaroustovsky M, Abramyan M, Rogalskaya E, Komardina E. The use of lipoprotein apheresis for the
treatment of high-risk patients with elevated lipoprotein(a) and hypercholesterolemia. Vessel Plus 2019;3:9.
http://dx.doi.org/10.20517/2574-1209.2019.02

Received: 10 Dec 2018 First Decision: 20 Jan 2019 Revised: 21 Jan 2019 Accepted: 22 Jan 2019 Published: 22 Mar 2019

Science Editor: Alexander N. Orekhov Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Aim: To assess the safety and efficiency of H.E.L.P.-apheresis and cascade lipid-filtration in the treatment of severe lipid
disorders in high-risk patients.

Methods: From 2016 to 2018 we observed 6 patients hyperLDLemia and high Lp(a)emia (> 60 mg/dL). The first group
with H.E.L.P.-apheresis (n = 74 sessions) included 3 patients who underwent revascularization (coronary, femoral
arteries). In the second group with cascade lipid-filtration (n = 92 sessions) - one patients underwent revascularization,
two patients received drug therapy. Despite the lipid-lowering conventional therapy, no targeted low density lipoprotein
(LDL) was obtained.

Results: The patients of the 1st group had threefold decrease of LDL, in patients of the 2nd group LDL decreased by 68%.
At the same time, in both groups, we noted a decrease in Lp(a) after the procedure by 65%-68%. Despite a decrease
in high density lipoprotein (by 22%-29%) after lipid apheresis procedures, there was a positive trend in apoB100/apoA
index (a decrease of 33% after HELP-apheresis procedures and 60% after cascade lipid-filtration) and a decrease in
atherogenic index (38% and 53%, respectively). The changes in hematological and haemostatic parameters remained
within physiological intervals.

Conclusion: We noticed the successful application of lipid apheresis in patients with multifocal atherosclerosis and its
complications.
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.vpjournal.net