Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989-2017.

Pottle, Alison and Thompson, Gilbert and Barbir, Mahmoud and Bayly, Graham and Cegla, Jaimini and Cramb, Robert and Dawson, Tina and Eatough, Ruth and Kale, Vaishali and Neuwirth, Clare and Nicholson, Kirsty and Payne, Jules and Scott, James and Soren, Handrean and Walji, Shahenaz and Watkins, Suzanne and Weedon, Hazel and Nath Datta, Dev Borunendra (2019) Lipoprotein apheresis efficacy, challenges and outcomes: A descriptive analysis from the UK Lipoprotein Apheresis Registry, 1989-2017. Atherosclerosis, 290. pp. 44-51. ISSN 1879-1484.

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Official URL: https://linkinghub.elsevier.com/retrieve/pii/S0021...

Abstract

BACKGROUND AND AIMS

In 2008, the National Institute of Health and Care Excellence in the UK recommended that patients undergoing lipoprotein apheresis (LA) should be included in an anonymised registry. The UK Lipoprotein Apheresis Registry was subsequently established in 2011.

METHODS

Between 2011 and 2017, data was entered retrospectively and prospectively by seven LA centres in the UK for 151 patients. Twenty-two patients were involved in a research study and were therefore excluded from the analysis. Observational data was analysed for the remaining 129 patients.

RESULTS

Most patients had heterozygous familial hypercholesterolaemia (HeFH) (45.0%); 23.3% had homozygous FH (HoFH); 7.8% had hyper-lipoproteinaemia (a) (Lp(a)) and 24.0% had other forms of dyslipidaemia. Detailed treatment data is available for 63 patients relating to 348 years of LA treatment. The number of years of treatment per patient ranged from 1 to 15. The mean reduction in interval mean LDL-C from the pre-procedure baseline was 43.14%. The mean reduction in interval mean Lp(a) from baseline was 37.95%. The registry data also shows a 62.5% reduction in major adverse cardiovascular events (MACE) between the 2 years prior to, and the first 2 years following introduction of LA.

CONCLUSIONS

The data generated by the UK Lipoprotein Apheresis Registry demonstrates that LA is a very efficient method of reducing LDL-C and Lp(a) and lowers the incidence rate of MACE. LA is an important tool in the management of selected patients with HoFH and drug-resistant dyslipidaemias.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 07 Oct 2019 13:23
Last Modified: 07 Oct 2019 13:23
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2454

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